Author + information
- George Rodgers, MD* ()
- ↵*Biophysical Corporation, 10801-2 North MoPac Expressway, Suite 140, Austin, Texas 78759
The American College of Cardiology (ACC) Workforce Workgroup recently published its study of the cardiovascular (CV) workforce (1) and concluded that there is currently a significant shortage of cardiologists that is projected to worsen over the next 2 decades. Our workgroup did not attempt to determine the “right” number of cardiologists because this approach is too conceptual and dependent on assumptions that it may have little enduring applicability to the real situation. Notably, Weiner (2) determined that the health care system would have far too many specialists by 2000, but based his projections on a health maintenance organization staffing model that did not ultimately become the standard for the U.S. Many others (3–5) recently found the opposite, that we have a substantial shortage of specialists (refs).
Our workgroup chose to determine the demand for cardiologists using a market-based approach. We surveyed the employers of cardiologists. Private and academic practices are intimately in touch with the demands for their services in their regions and the limitations of their practices to deliver these services. The ACC and Medaxiom surveyed these employers in 2007 and received responses from 15% of the workforce. Our metric was open positions for cardiologists. Our consultants at the Lewin Group and the Association of American Medical Colleges (AAMC) further analyzed Medicare and commercial insurance data to assess the demand for CV services trends. From the standpoint of the marketplace, there is a significant shortage of 4,286 cardiologists.
Certain demand drivers such as the aging of the baby boomers, the epidemic of obesity, expansion of insurance coverage under reform, and technological advances suggest that these demands will increases over the next decade. Dr. Marine points out recent studies (the Dartmouth Atlas of Health Care in particular) that suggest overuse of CV services in certain regions of the U.S. (6). The ACC strongly supports appropriate use and a focus on quality of care. Inasmuch as the ACC and health care reform can influence appropriate use, we may see some decrease in demand. The ultimate effect of all these drivers can only be viewed in retrospect, and toward this end, the ACC Workgroup intends to survey practices on an ongoing basis.
The most alarming result of our study was the age distribution in the current workforce. Forty-three percent of our cardiologists (10,261 of 23,662) are 55 years or older. This is the age when those who have worked hard for many years start to consider retirement. With financial portfolios recovering from the 2008 economic meltdown and the present threat of substantial changes in reimbursement and onerous regulation, our greater concern is whether we will be able to adjust to the early retirement of several thousand cardiologists in a system that is annually replenished by 750 new cardiologists. Even in a scenario of optimal use of CV services this would represent a critical shortage that everyone would recognize.
Please note: Dr. Rodgers is the Chair of the ACC Workforce Task Force.
- American College of Cardiology Foundation
- Rodgers G.P.,
- Conti J.B.,
- Feinstein J.A.,
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- Cooper R.A.,
- Getzer E.G.
- Bureau of Health Professions, Physician Supply and Demand Projections to 2020
- Council on Graduate Medical Education, Reassessing Physician Workforce Policy Guidelines for the U.S. 2000–2020