U.S. Faces Shortage of Heart Surgeons

Too many aging Americans, too few new doctors spell trouble, experts say

Posted: September 10, 2009

By Amanda Gardner
HealthDay Reporter

THURSDAY, Sept. 10 (HealthDay News) -- The United States faces a dire shortage of cardiologists in the coming years, a shortage made even more critical given the increasing demands of a population rapidly growing older and heavier.

The shortfall could reach 16,000 cardiologists by 2050, according to a new report from the American College of Cardiology (ACC). As of right now, there are already 3,000 too few cardiologists in this country, the report finds.

"We have a gap now, and it's a tremendous gap, and our feeling is that it's going to be getting worse as we have the baby boomers cresting at age 65," report author Dr. George Rodgers, chairman of the ACC's Board of Trustees Workforce Task Force, said during a Thursday teleconference. "Our guess is that the deficit in cardiologists is going to probably widen, and even double, by the time we get to 2030 or 2050."

That means that in order to keep up with demand, the United States will need to have twice as many cardiologists in 2050 as it had in 2000.

"In order to care for increasing numbers of patients who are managing their multiple chronic conditions, we will of course need additional highly skilled people," said Dr. Janet Wright, the ACC's vice president for science and quality.

Yet the forces working against this are formidable, including a dwindling number of training spots available for budding cardiologists.

The report appears in the Sept. 22 issue of the Journal of the American College of Cardiology.

Heart disease is the top killer of both men and women in the United States.

According to the American Heart Association, at least 80 million people in the United States had at least one type of cardiovascular disease in 2006, including a history of acute heart attack (almost 8 million individuals), stroke (6.5 million people) and heart failure (5.7 million).

In 2005, 864,480 people died of heart disease, but this is actually an improvement. Over the past eight years, both deaths and disability attributable to heart disease have gone down 29 percent, the ACC reported.

"Even though there has been this nice drop, it translates into more and more people managing multiple cardiac problems in addition to other health issues," Wright said. "Our population is living longer, thank goodness, but we're going to need additional highly skilled people to help manage them."

"In a way, we're victims of our own success," Rodgers added.

In the study, the authors surveyed people involved in the hiring of cardiologists. Based on that survey, the ACC projects a shortfall of up to 16,000 of these professionals within the next four decades.

The main reason: a 25 percent reduction in the number of slots available for cardiology training in medical schools spurred by an assumption that family practitioners would be able to provide much of the care for heart disease patients.

That has not turned out to be the case.

Other findings from the report:

One clear solution would be to increase the number of fellowship positions available. Currently there are 1.5 candidates for each available position, Rodgers said. "It's not a pipeline problem," he said, but rather a funding problem.

A Worried Wife

7As the wife of a cardiologist, I am downright worried.

My husband spent years training and now, just as he is going to begin his practice and recuperate the earnings he sacrificed becoming an invasive cardiologist, Obama's administration has decided to impact our future and fund their healthcare reform on the backs of healthcare practitioners. Here is the kicker. I voted for Obama, and I believe in reform, but what I see happening before me is not what I envisioned. What happened to ending the war in Iraq? The savings from that act alone would fund this overhaul. The result of the 26% cuts in medicare reimbursement (between now and 2012), along with those that will surely come with healthcare reform will be ruinous to cardiology. There is already a serious deficit in cardiology care within the country. People, we have to wake up and try to stop this before the cascade of events plays out. What will be next?

I am very disappointed that the funding is coming out of the doctor's pockets. We already pay a boat-load of taxes. When I think about the years of hard work, the call, the long hours, the holidays spent away from family, the countless sacrifices that most people don't understand, I just shake my head. Sadly, most people think that doctors make too much money. Consider this: my husband didn't start making a decent salary until he was 36 years old! It took him 10 years total to become an interventional cardiologist (med school, internship, residency, general fellowship and interventional fellowship). If you include undergrad, he spent 14 years learning to save lives.

I don't think the politicians understand what a doctor goes through to specialize. While I applaud the effort to balance things for the primary care provider, I can't ignore that a cardiologist spends an additional seven years training to do what he does. Who would these policy-makers want working on their heart? Who do you want working on yours?

We should all be very, very worried friends. Bad things are coming our way, and I am sick that I helped swing the country in this direction. I trusted Obama to make smart decisions. I hoped that he would cut government waste. Instead he is behaving like previous politicians. He will fund his program on the backs of hard-working physicians who truly deserve to be paid a premium for the intense stress and pressure under which they practice.

My husband stands in a cath lab all day wearing lead, exposing himself to radiation. In his late thirties, his back is already bad, his shoulder is shot, his knees hurt, and he will need to retire early. What will happen to our family?

A Caper of IL @ Dec 07, 2009 00:41:27 AM

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