A Pulmonologist is a medical professional specializing in the lungs and the entire respiratory system. This field, known as pulmonology, focuses on diagnosing and treating conditions affecting the airways, air sacs (alveoli), and blood vessels of the lungs. A pulmonologist is a physician who has completed extensive training, including a residency in internal medicine followed by a specialized fellowship. They are the specialists for chronic or complex breathing problems, distinct from a general practitioner who manages routine respiratory illnesses.
The Role of a Pulmonologist
A pulmonologist manages a broad spectrum of acute and chronic diseases that compromise respiratory function. They are responsible for the long-term management of common conditions like chronic obstructive pulmonary disease (COPD) and asthma. Their clinical practice also extends to complex infections, such as severe pneumonia, and conditions affecting the lung tissue, including pulmonary fibrosis and sarcoidosis.
The specialist evaluates and manages pulmonary vascular diseases, such as pulmonary hypertension. They are frequently involved in the diagnosis and staging of lung cancer. Many pulmonologists have expertise in sleep-disordered breathing, including obstructive sleep apnea. For patients requiring life support, such as mechanical ventilation, a pulmonologist often oversees this care.
Diagnostic and Interventional Tools
Pulmonologists utilize specialized tools and procedures to diagnose and intervene in respiratory illnesses. A foundational method is the use of pulmonary function tests (PFTs), including spirometry, which measure lung volumes, capacity, and rates of flow to assess impairment. They also interpret advanced medical imaging, such as chest X-rays and computed tomography (CT) scans, to visualize lung abnormalities and detect conditions like nodules or tumors.
For direct examination and tissue sampling, pulmonologists perform bronchoscopy, inserting a flexible tube with a camera into the airways. This procedure allows visualization of the trachea and bronchi, removal of foreign bodies, and collection of tissue samples. Advanced techniques like endobronchial ultrasound (EBUS) guide the sampling of lymph nodes and masses outside the airway wall, improving cancer staging accuracy. Another common procedure is thoracentesis, which uses a needle to remove excess fluid (pleural effusion) from the space between the lung and the chest wall.
Collaborating Specialists in Respiratory Care
Comprehensive care for a patient with a lung condition often requires collaboration with other medical specialists. When surgery is required, such as for lung cancer or severe emphysema, the pulmonologist works closely with a Thoracic Surgeon. The pulmonologist provides the initial diagnosis and manages the patient’s non-surgical respiratory issues before and after the operation.
Respiratory Therapists focus on the technical administration of treatments, such as managing mechanical ventilation and teaching patients how to use inhalers. For individuals with lung cancer, the pulmonologist consults with Medical Oncologists, who manage chemotherapy, and Radiation Oncologists, who oversee radiation treatment. This multidisciplinary team approach ensures all aspects of a patient’s complex condition are addressed.