Shortage of cardiothoracic surgeons expected
■ New study says half of physicians in the specialty are older than 55 and nearing retirement.
By Tanya Albert Henry — Posted Aug. 14, 2009
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By 2025, the U.S. could be short 1,500 cardiothoracic surgeons, or 25% of the specialists required to meet the projected needs of an aging population.
A study in the Aug. 11 Circulation shows that the number of practicing cardiothoracic surgeons fell in 2003 for the first time in 20 years, and an exodus is expected to continue over the next decade. By 2020, the supply of cardiothoracic surgeons will decrease by 18%, according to the study (link).
"We were surprised at how big this deficit is going to be," said study co-author Irving Kron, MD, chair of surgery at the University of Virginia in Charlottesville. "Right now you can get the care you need. ... But [the shortage] is going to be a big deal."
Half of the cardiothoracic surgeon work force is older than 55 and nearing retirement, according to the Circulation study. That finding mirrors surveys by the Society of Thoracic Surgeons and American Assn. for Thoracic Surgery suggesting that 54% of cardiothoracic surgeons expect to retire within 12 years.
On top of that, fewer new physicians are choosing the specialty. Between 2004 and 2006, there were not enough applicants to fill training programs. Only 84 of 126 positions offered through the national match for residencies were filled for July 2007, the Circulation study said.
Researchers found a number of reasons for the declining interest:
- The number of coronary artery bypass grafting operations, a mainstay of the profession, decreased by 28% between 1997 and 2004.
- Medicare reimbursement for coronary artery bypass grafting operations decreased 38% since 1996.
- Recent graduates of cardiothoracic surgical programs have encountered problems finding jobs after their training.
Dr. Kron said leaders in the specialty want to get the word out that surgeons are needed -- and that need will grow.
That's because cardiothoracic surgeons care predominately for the elderly, and the elderly population is projected to grow by 50% by 2020 and nearly 100% by 2030 to an estimated 71.4 million Americans. Researchers expect a 20% increase in the per capita rates of non-coronary artery bypass grafting operations and general thoracic operations.
Medicare data show that Americans younger than 80 were having fewer coronary artery bypass grafting operations between 1999 and 2004, but those older than 80 were having more. According to the hospital database Nationwide Inpatient Sample, other procedures that surgeons perform have increased over the past decade, including a 28% increase in valve procedures.
"The shortage of cardiothoracic surgeons within the next 10 years could diminish quality of care if non-board-certified physicians expand their role in cardiothoracic surgery or if patients must delay appropriate care because of a shortage of well-trained surgeons," the study said.