Where’s a good cardiologist when you need one?

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Patrick White of MedaxiomWe face a paradox. At the very time when more Americans are reaching senior status than ever before…at the very time when more of us will be requiring the specialized services from medical experts such as cardiologists…we’re beginning to see unmistakable signs that there may simply not be enough of them to go around to meet our growing needs.

You don’t have to look far to see the reasons, and they’re based on the bottom line. Experts like cardiologists have spent years perfecting their craft and take justifiable pride in their accomplishments. Increasingly, however, they’re being financially buffeted from all sides, and a lot of good doctors are deciding that the financial rewards associated with taking a specialty path, whether it’s cardiology or another field, no longer justifies the years of preparation, the greater workload, the increasingly exorbitant financial costs and the red tape associated with it.

For instance, I’ve seen reports that indicate that the average cardiologist, just starting out, has racked up educational costs of up to one million dollars that must be paid back. That’s a huge burden for anyone to bear. Moreover, the pressures of work are starting to take their toll: a nationwide survey that we conducted last year revealed that cardiologists are being asked to see more patients than ever, and that they’re administering more tests than ever before…both of these, consistent with their commitment to provide the highest quality health care possible.

That commitment comes with a price: the survey found that the average cardiologist pays out almost two-thirds of a million dollars in overhead annually, and is under greater financial pressure than ever before, with private and government insurers tightening or even trying to eliminate forms of the financial remuneration cardiologists have fairly expected for years.

In plain English, it’s tougher than ever to keep the doors open.

Small wonder, then, that an increasing number of existing cardiologists and other specialists are folding their practices into larger healthcare organizations, such as hospitals and large health systems.

More than half of the cardiologists we surveyed said they’ve already done so or are seriously thinking about it, meaning that the days of the independent cardiologist may be numbered. And a growing number of medical students appear to be deciding that the increased financial and regulatory pressures simply aren’t worth the time and work needed to focus on a specialty practice.

This is not to say that there won’t be a cardiologist available if you need his or her help. There are thousands of men and women who’ve devoted their lives to providing a superior level of care, and who are trying to successfully balance their professional responsibilities with today’s financial realities.

But at the very time when, as a nation, we’re being challenged to make health care more accessible and affordable to a greater number of people, it may be time to pay similar attention to those providing that care. We should be willing to consider the other side of the equation and make it easier, not more difficult, for cardiologists and other specialists to continue providing the kind of care an increasing number of Americans will come to both expect and demand.

Patrick White is President of MedAxiom (www.medaxiom.com), a comprehensive subscription-based service provider, information and networking resource exclusively for cardiology practices encompassing academic cardiology organizations, hospital-owned cardiology practices as well as physician-owned cardiology groups.

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{ 4 comments… read them below or add one }

josephmartins September 22, 2010 at 8:34 am

What sort of reform would result in net savings (i.e. lower costs not displaced costs) for cardiologists and health care practitioners in general?

AND, would those savings be passed along to patients as lower costs for care? I have an uneasy feeling that any savings would not make its way to patients.


Steve Friedberg September 22, 2010 at 10:15 am

I don’t know that there’s an easy answer. Ideally, everybody takes a bit of ownership in this one: patients become more focused on maintaining healthy behavior, insurers become more understanding and less bottom line focused, manufacturers and drug companies agree to take less profit in the name of the greater good, and their shareholders understand this will mean slightly less profit.

Yes, I know. Dream world. But as long as everyone continues to insist that everyone else should make the needed sacrifice, nothing will be done. And we will see the secondary effects like fewer medical specialists, precisely as guys like you and me are going to be needing their help.


Anne Zieger September 22, 2010 at 10:26 am

I have to agree with Steve, pretty much across the board. The only thing I can add is that administrative simplification could save a bundle, so much that it could possibly outshine even the measures Steve has outlined. The Medical Group Management Association, for example, estimates that it would save $9.4 billion over 10 years if certain claims transactions were simplified.

All told, it’s one heck of a problem. But even if the industry was willing to come together to solve these problems, we’re in stall mode. Until reform kicks in, I doubt stakeholders here will do anything but cover their butts.


Steve Friedberg September 23, 2010 at 10:48 am

Good point, Anne…but to advance Joe’s argument: if those $9.4 billion in cost savings are realized, how does that benefit end users?

If everyone is going to share the burden equally, they should be entitled to share in the benefits.


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