ACC CardioCareer & CME Guide - March 2008v8 - (Page 12) Cardiology’s Workforce Crisis: Growing Demand, Diminishing Supply T he United States is facing a growing shortage of cardiovascular (CV) specialists that will hinder access to care and undermine the vital research efforts of CV physician researchers. Number of Elderly Will Double by 2030 80 Population (in millions) 70 60 50 40 30 20 10 0 2000 2010 2020 2030 65+: 104% increase from 2000 to 2030 This, in addition to the aging of the population and rising risk factors for CV disease, has led to a shortage of cardiovascular specialists. What Is Driving the Demand for CV Specialists? Cardiovascular “Demand Catalysts” • Population: An aging population with more chronic cardiac patients living longer. • Metabolic syndrome: The “epidemics” of obesity and type 2 diabetes leading to more CV disease. • Superior outcomes: Compelling evidence that heart patients have better outcomes if they receive at least part of their care from a cardiologist. • Managed care decline: The decline of managed care’s gatekeeper model that blocked access to specialists. • Consumerism: A better-informed public with growing expectations in terms of their personal health care. • Women: Increasing awareness among women that they are more likely to die from CV disease than from cancer. • Clinical innovation: Continuing technological and procedural innovations and their rapid diffusion into practice. • Screening: More widespread use of CV screening tests that result in more referrals and procedures. • Subspecialization: Progressive subspecialization within cardiology that results in more “internal” referrals. Source: Fye WB, Hirshfeld JW, et al. Cardiology’s workforce crisis: a pragmatic approach. Presented at the 35th Bethesda Conference, Bethesda, Maryland, October 17-18, 2003. J Am Coll Cardiol 2004;44:215-75. Supply of CV Specialists A total of 174 Accreditation Council for Graduate Medical Education (ACGME)-accredited CV disease fellowship training programs provide the necessary training to produce the cardiovascular specialists that treat patients and conduct valuable research efforts. In the 2006-2007 academic year, these programs collectively had 2,427 ACGME-approved training positions, of which 2,302 were filled. The 125 positions that went unfilled were vacant largely because the institutions lacked the funding to fill those slots with one of the many qualified applicants that were denied admission. (Continued on the following page) Source: US Census Bureau Why a Shortage? In the early 1990s, the commonly held belief was that the United States was producing too many specialist physicians, including cardiologists. The rapid growth of for-profit managed care with its gatekeeper model and obstacles to specialty services contributed to this belief. As a result, the number of first-year and total adult cardiology training positions fell by 20% and 10%, respectively, between 1994 and 1999. The managed care model did not gain traction as expected, and access to specialists has not been limited as expected. The projected surplus did not come to fruition; however, the number of first-year training positions and total adult cardiology trainees is still below 1994 levels. Charlotte Cardiology Associates, a leader in providing cardiac care, is currently recruiting highly motivated, leadership driven physicians to join their team. Charlotte Cardiology has seven locations in Charlotte and the surrounding communities. The physician team in Monroe, NC is looking for an invasive cardiologist to join their busy practice. Qualified candidates will be echo and nuclear trained, peripheral vascular interventional skills a plus. Monroe, located in Union County, is now the fastest growing County in the Charlotte Region. For more information or to submit a CV for consideration, contact Amy Jacobsen at Physician Services (800) 847-5084 or (704) 3555023 Fax (704) 355-5033. Email amy.jacobsen@carolinashealthcare.org 12 American College of Cardiology CardioCareer & CME Guide
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