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Ana Fullmer, 202-375-6229; afullmer@acc.org
September
10, 2009
New Survey Reveals Critical Shortage in Number of Cardiologists
Available to Care for Growing Number of Americans with Heart
Disease
ACC issues report to sound alarm and outline
important solutions
Despite the fact that heart disease remains the leading killer
of Americans, there aren’t enough cardiologists to care
for these patients, according to a report released today by
the American College of Cardiology (ACC). This finding is
especially concerning given that the demand for cardiology
services is only expected to increase amid an aging baby boomer
population, the escalating obesity epidemic and as more people
are living longer with chronic heart disease. In fact, based
on the new data, authors project the number of practicing
cardiologists will need to double between 2000 and 2050 in
order to adequately take care of anticipated new cases of
heart disease.
“We have a significant shortage of 3,000 cardiologists
in the workplace today, and all indicators are that it’s
going to get worse if we don’t do something,”
said George P. Rodgers, M.D., F.A.C.C., chair of the ACC Board
of Trustees Workforce Task Force and a cardiologist in private
practice in Austin, TX.
If current trends persist, Dr. Rodgers says there will be
16,000 too few cardiologists in 2050. These estimates are
based on the analysis of a survey of employers within private
and academic practices—those who hire cardiologists
and are keenly aware of the market needs and willing to pay
for cardiologist services—to assess whether and how
many open positions there are to meet demand and provide quality
care, as well as other observed trends in cardiovascular care.
“Patients are surviving heart attacks and are living
better and longer with heart disease, which is a good thing,
but they will need ongoing cardiac care and surveillance,”
Dr. Rodgers said. “Without boosting our supply of cardiologists,
we may threaten the incredible progress we have made to date.”
According to ACC, the mortality and morbidity related to
heart disease has been reduced by 29 percent over the past
8 years.
The full report, published in the September 22, 2009, issue
of the Journal of the American College of Cardiology,
also outlines factors that influence physicians to become
a cardiologist, the underrepresentation of women and minorities
in the field, as well as the lack of an adequate number of
training spots and funding.
The current shortage stems from a decision by policymakers
in the early 1990s that, with the ushering in of managed care,
assumed the family practitioner would be the main gatekeeper
for people with heart disease. This resulted in a 25 percent
cut in the number of cardiology training spots.
In addition to the expected demand for cardiology services
over the next 20 years and the lack of training opportunities
and funding in cardiology, several other issues are fueling
experts’ concern:
- More than 40 percent of all cardiologists in the current
workforce are over the age of 55 and may retire early for
a variety of reasons (e.g., malpractice insurance costs,
cuts in reimbursement, arduous call schedules with no opportunity
to “wind down” closer to retirement).
- There is an underrepresentation of minorities and women
in cardiology; while African Americans and Hispanics comprise
25 percent of the U.S. population, they only represent 6
percent of cardiologists in active practice, and women only
comprise 12 percent of cardiologists.
- Non-physician providers are underutilized even though
they could help to work up, screen, educate and discharge
new patients
- Proposed Medicare cuts in the range of 25 to 42 percent
for key cardiology services may hinder access to services
that have improved countless lives by diagnosing and treating
cardiovascular disease
The report offers suggested solutions, including expanding
the number of fellowship positions, establishing better work-life
balance, reducing known “hassle factors” that
may encourage early retirement, creating incentives for underrepresented
minorities to consider cardiology, as well as encouraging
a team-based approach to cardiology care that leverages the
skills and expertise of other non-physician providers (e.g.,
nurse practitioners, physician assistants).
“We need to advocate for more training spots and funding
for cardiovascular specialists and, in the meantime, find
creative and more effective ways of delivering care,”
said Alfred A. Bove, M.D., F.A.C.C., president of the ACC.
“Team-based care is a major opportunity for improving
the current and future workforce crisis.”
ACC is actively promoting team-based care by working with
non-physician providers and practice administrators and through
the development of a curriculum and workshop to educate cardiologists
about how to work effectively with other providers.
The Workforce Task Force was started by ACC following the
35th Bethesda Conference in 2004. The present survey was conducted
by ACC and the American College of Cardiology Foundation with
the Lewin Group and the Association of American Medical Colleges
to better understand the factors affecting the supply of and
demand for cardiologists, the magnitude of the shortage and
projected trends.
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The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 36,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
national registries for the measurement and improvement of
quality care. More information about the association is available
online at www.acc.org .
The American College of Cardiology (ACC) provides these news
reports of clinical studies published in the Journal of
the American College of Cardiology as a service to physicians,
the media, the public and other interested parties. However,
statements or opinions expressed in these reports reflect
the view of the author(s) and do not represent official policy
of the ACC unless stated so.
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