Questions such as this from proactive, increasingly knowledgeable patients place a physician (resident, fellow or newly minted attending) on the horns of an ethical dilemma. Although fellows are closely supervised and trained under a gradually increasing responsibility principle (based upon subjective evaluation), a time will come when there is no one available to back you up in the catheterization lab.
Fact: Someone has to be a physician’s first case of any given type. However, no one really wants to be that person.