"The reasons for this declining interest appear to be multiple," according to the investigators. For one thing, they note, the number of coronary artery bypass graft operations, in which surgeons reroute blood flow around block arteries that supply the heart, and which account for a large part of the surgeons' income, fell by 28 percent between 1997 and 2004. Many of these operations were replaced by stents -- mesh tubes that prop blocked arteries open -- inserted by cardiologists, not heart surgeons.But then, this is what proponents of cutting specialists' income want: fewer costly specialists, all in the name of "cost savings."
Furthermore, Medicare reimbursements for bypass surgery have fallen by 38 percent. Finally, newly trained cardiothoracic surgeons have had trouble finding jobs.
For the supply of cardiothoracic surgeons to be adequate in the coming decade would require elimination of coronary artery bypass operations, and numbers of young surgeons entering the field must be as high as in the 1990s. Since these are both highly unlikely, the researchers continue, the number of surgeons entering training in cardiothoracic surgery will probably be "inadequate to care for the US population in the coming decades."
Reference: "Shortage of Cardiothoracic Surgeons Is Likely by 2020" Circulation Published online before print July 27, 2009, doi: 10.1161/CIRCULATIONAHA.108.776278.