Monday, July 27, 2009

You Get What You Don't Pay For

Like fewer cardiothoracic surgeons:
"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.

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."
But then, this is what proponents of cutting specialists' income want: fewer costly specialists, all in the name of "cost savings."


Reference: "Shortage of Cardiothoracic Surgeons Is Likely by 2020" Circulation Published online before print July 27, 2009, doi: 10.1161/CIRCULATIONAHA.108.776278.


DrV said...

Unreal. Some day we'll all pay for this

shadowfax said...

I dunno. It seems to me that every specialty society (including my own) has come out with peer-reviewed studies showing that by some random date in the future there will be a terrible terrible shortage of whichever specialty is sponsoring the study.

Perhaps there's just going to be a shortage of doctors -- some say that is the case.

but if you take into account the fact that med students are *not* going into primary care, and there are projected shortages of ER docs, cardiologists, OBs, thoracic surgeons, etc, it does beg the question of what the hell all those new doctors *are* going into...

Anonymous said...

shadowfax-have you seen the recent matchdata for cardiothoracic surgeons? not pretty at all.
i don't believe that even with the cuts, the remaining trainees are getting good valvular experiences, outside a few centers.
lastly, while i hear what you are saying about projected shortages, the fact that graduates today have trouble finding jobs is very concerning. it's not like they are pediatric cardiothoracic surgeons where you can see they would need a huge population to support them. i think this specialty is in danger for real. i see ct surgeons moving on in lots of hospitals i work at, trying to get enough work to survive. i think that is behind some of their af ablation interest and rekindled interest in implanting devices.

Anonymous said...

What does a large pizza and a cardiothoracic surgeon have in common?

Both can barely feed a family of four.