Severe shortage of cardiothoracic surgeons predicted by 2025

MedWire News, 28 July 2009

The number of active cardiothoracic surgeons in the USA is set to fall by around 21% by the year 2025, while demand for their services could increase by 46% in the same period, according to the latest study estimates.

The authors of the new study warn that such a shortage 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.

Any effort to expand the cardiothoracic surgery workforce for 2020 would need to begin today because cardiothoracic surgeons undergo a longer period of training than any other specialty,” Atul Grover (Association of American Medical Colleges, Washington, DC) recommend in the journal Circulation.

Recently, leading clinicians have expressed concern about the future supply of cardiothoracic surgeons, as half of the active workforce is over 55 years of age and nearing retirement.

The number of practicing cardiothoracic surgeons fell in 2003 for the first time in 20 years, and a large exodus of cardiothoracic surgeons from the active workforce is expected over the next decade.

At the same time, there has been a marked decline in the number of well-qualified applicants to training positions; in 2004, 2005, and 2006, there were more positions than applicants to training programs. Only 84 of 126 positions offered through the national match were filled for July 2007.

Using 2005 data from the American Medical Association Masterfile and Medicare claims forms, Grover and colleagues projected future supply and demand for cardiothoracic surgeons under alternative scenarios in which current patterns of healthcare use and delivery will continue into the future.

Notably, their model assumed the elimination of open revascularization by 2025, which is based on the 28% decrease in coronary artery bypass graft surgery seen between 1997 and 2004 and the accompanying 121% rise in cardiac stent placement – a procedure performed by cardiologists not cardiac surgeons.

Grover and colleagues found that even in the most favorable scenario, supply for cardiothoracic surgeons failed to meet demand.

They comment: “According to these statistical models, the USA is facing a severe shortage of cardiothoracic surgeons within the next 10 years.

By 2025, it is probable that there will be a shortage of at least 1500 surgeons or 25% of the likely projected need.