Health and population trends could increase demand for cardiothoracic surgeons in the U.S. far greater than the diminishing supply and, therefore, delay care, according to a report published July 27 in Circulation.
The Association of American Medical Colleges' (AAMC) Center for Workforce Studies found that the demand for cardiothoracic surgery services is projected to increase by 46 percent by 2025 (compared to 2005), while the supply of the surgeons is expected to decrease 21 percent during that period.
The supply for cardiothoracic surgeons is already dwindling, according to the study's senior author Irving L. Kron, MD, chair of surgery and professor of thoracic and cardiovascular surgery at the University of Virginia Health Sciences Center, based in Charlottesville, Va.
"The number of active cardiothoracic surgeons has fallen for the first time in 20 years," Kron said. "In 2007, 33 percent of available thoracic surgery fellowship positions went unfilled in the National Resident Matching Program. Surveys of residents in training in cardiothoracic surgery indicated that many were having difficulty finding employment after completing five years of general surgery training, followed by two years of a cardiothoracic surgery fellowship."
This could be, in part, because the use of CABG -- the most common procedure performed by cardiothoracic surgeons -- is declining, down 28 percent from the period of 1997-2004. Meanwhile, cardiac stent placement, performed by interventional cardiologists rather than surgeons, has increased, up 121 percent from 1997-2004.
In general, population groups with less access to medical care, especially early care, tend to have poorer health outcomes; so, these populations could suffer most. And though there are some non-surgical options for treating cardiac patients, the shortfall of cardiothoracic surgeons comes at a time when cardiologists will likely be in short supply as well, according to the paper.
The impending shortage of cardiothoracic surgeons is an "important threat," said Timothy Gardner, MD, immediate-past president of the American Heart Association (AHA), a cardiac thoracic surgeon and medical director for the Center for Heart and Vascular Health at Christiana Care Health System in Newark, Del.
"It is the AHA's mission to promote the cardiovascular health of the population and effectively treat people with cardiac conditions," he said. "If the supply of key specialists, such as heart surgeons, declines, that could impact the health of the population and physicians' abilities to effectively treat people with heart disease."
The American Association for Thoracic Surgery (AATS) and the Society of Thoracic Surgeons (STS) funded the study.