To kick off our 2009 Legislative Conference coverage, former ACC Texas Chapter Governor and current ACC Board of Trustees member George Rodgers, M.D., F.A.C.C. will discuss a recently released study on the impending cardiovascular professional workforce shortage, which appears in the Sept. 22 issue of Journal of the American College of Cardiology. Dr. Rodgers is president and chief medical officer of Biophysical Corporation, a company dedicated to advancing clinical knowledge through its research in the field of biomarkers, and a practicing cardiologist in Austin. As part of the release of the study, Dr. Rodgers and ACC SVP of Science and Quality Janet Wright, M.D., F.A.C.C., conducted a phone conference with reporters, which is available at the end of this post.
There are many issues that cardiovascular professionals need to talk to lawmakers about to better inform health care policy and improve the health care system. As Margo Minissian, CCA, said in her post last month: Cardiovascular professionals are the “experts on health care and our lawmakers need us to get up-to-date on the different issues.” My commitment to advocacy is why I’m here in Washington, D.C., for the ACC’s 2009 Legislative Conference.
At this moment, two of the hot topics are payment reform and health care reform. However, an underappreciated advocacy topic for cardiologists, but one I feel is highly important, is addressing the cardiology workforce crisis. My colleagues on the ACC Board of Trustees Workforce Task Force and I on Thursday published in JACC the results of a survey finding that an inadequate supply of cardiovascular specialists will be available to treat the projected 20 million more Americans that will have heart disease by 2020.
Some of the study's findings:
Currently there is a significant shortage of over 3,000 cardiologists in the workforce. Only approximately 800 new cardiologists complete fellowships every year in the U.S.
Forty-three percent of cardiologists in the current workforce are over the age of 55 – nearing the point in their careers that they might consider retirement.
There are going to be much greater demands in the next 20 years for cardiology services based on such drivers as population (baby boomers), the epidemic of obesity and the anticipated increase in prevalence of diabetes and concomitant cardiovascular diseases.
Health care reform may further drive demands for more cardiovascular specialists.
Not surprisingly, the report also found significant disparities in representation of women and minorities. Women represent about 12 percent of general cardiologists, 10 percent of interventional cardiologists and EPs and 30 percent of pediatric cardiologists; however, compare these rates to the rate of female medical students – 50 percent – and it’s clear how much room for improvement there is in encouraging women to pursue cardiology. Meanwhile, Hispanics and African Americans represent only 6 percent of the current cardiovascular workforce, compared to 25 percent of the general U.S. population.
What To Do About It
What does this all mean? In order to meet the growing demand for cardiovascular services, more is going to have to be done to recruit cardiologists and other nonphysician practitioners to the cardiovascular world. Part of this can be done through advocacy: we need more government funding for fellowship training positions in general cardiology. The government needs to help promote practice efficiency, such as subsidies for EHRs, a reduction in administrative burden and tort reform. Advocacy also will be needed to create more opportunities for under represented minorities, including shorter fellowship training and increased mentorship. We’re also able to meet the growing demand through increased use of team-based care, which will require more funding to train nurses and physician assistants on cardiovascular-specific care.
The shortage of cardiovascular professionals is a significant problem that will only get worse if no action is taken. Read more about the workforce study, and additional ways to reduce the shortage, in the most recent issue of JACC.
* Dr. Rodgers' post is part of a monthly series of guest posts by ACC leadership. Check back next month to see which ACC leader is sharing his or her thoughts on health care reform!