This article is more than 5 years old. Information may no longer be current.
After the Bethesda Conference, where are we with the CV workforce shortage?
Finally, progress is being made toward a solution; stay tuned.
Click Here to Manage Email Alerts
More than four years after the Bethesda Conference was published in the Journal of the American College of Cardiology, we still don’t have a solid plan in place to tackle the shortage of cardiologists.
But finally, there’s movement toward a solution for this emotionally charged issue. The last week of February, the American Board of Internal Medicine convened a stakeholder meeting to discuss how new internal medicine/subspecialty training models, including cardiology, might move forward into pilot programs. Eric Holmboe, MD, senior vice president for quality research and academic affairs at ABIM, said that the ABIM board of directors plans to take up the issue, and the results of that February get-together, in a June meeting. One of the discussion items is moving toward a competency-based outcomes model that may allow for shortening the total internal medicine-cardiology training tract time for talented trainees.
|
|
“We are working hard to keep this conversation going,” he told me. “There’s a lot of emotion around this issue on multiple sides.”
Where we stand in 2009
The last time I tackled this issue for Cardiology Today readers – November 2005 – the Bethesda Conference report had taught us that a shortage of cardiologists would continue to increase and affect us most in the 2010s and 2020s as the Baby Boomer generation encounters heart disease and Baby Boomer physicians retire.
Today we face a deficit of more than 4,000 general and interventional cardiologists and pediatric cardiologists, according to George Rodgers, MD, who has been instrumental in examining the issue for the ACC. Although there are an abundance of adequately qualified applicants, Bruce Fye, MD, who was chair of the Task Force on Workforce at the time of the Bethesda Conference publication, said there are still some centers that are not filling their cardiology positions due to the state of the U.S. economy.
There are reasons to believe it may be too late to influence the shortage. Even if something were implemented now, we would still have to wait five to six years to see a change in the numbers of cardiologists completing training. We are experiencing declining death rates due to CVD, and the severity of MI is declining, according to recent research. We’ve made progress in risk factor modification including smoking cessation among Americans. Those declines might translate to a lesser need for CV specialists, assuming the trends continue.
Fye said he thinks some cardiologists ready to retire in the next few years may not, also because of the economy. This of course would keep a number of older cardiologists in the workforce.
However, we have an epidemic of obesity coming our way. With obesity comes metabolic syndrome and diabetes, and the comorbidities that go along with it — including CVD.
If we do nothing to help prevent the shortage, we face an estimated deficit that will be 16,000 cardiologists by 2025.
It’s been a long pathway to get to where we are today and the steps toward action appear small. If we shorten the educational tract of the cardiologists from six years to five years, we could train 20% more new cardiology fellows every year.
Please stay tuned to read more about this topic in Cardiology Today. The good news in all of this is that the ACC and the ABIM are working to come up with short-term and long-term solutions, which I’ll discuss in my next editorial on the issue. The workforce and our future as a profession are important for all of us to stay informed about.
Carl J. Pepine, MD, is Eminent Scholar, Professor of Medicine, Division of Cardiovascular Medicine at the University of Florida, Gainesville. He is the Chief Medical Editor of Cardiology Today.