We all know there’s a growing cardiologist shortage, but American cardiovascular care might hit its breaking point, with a Medicus Healthcare Solutions analysis now projecting that the shortage will only get bigger, and will hit rural communities the hardest.
- CVD affects nearly half of U.S. adults with its prevalence expected to rise, driven by aging demographics and increasing CVD risk factors.
- The cardiology workforce itself is also aging, with 29% of cardiologists now over 65 years old and an average age of 58.
To quantify the problem, Medicus examined over 34k U.S. cardiologists (24.9k general, 5.2k interventional, 2.9k electrophysiologists) and created supply-demand projections through 2036 that revealed several bottlenecks.
First there’s a well known geographic hurdle:
- Nearly half of U.S. counties don’t have a single cardiologist.
- Rural counties face a 54% higher CVD mortality rate.
- Northeast states have double to triple the number of cardiologists per capita compared to the most rural states (14-16 vs. 5-7 per 100k).
Then there’s a fellowship training mismatch:
- Cardiovascular disease programs saw 35.6% of applicants fail to match.
- Meanwhile interventional cardiology (23.1% unfilled) and advanced heart failure/transplant (40.2% unfilled) also faced insufficient applicant interest.
And even when a cardiologist is done training, recruitment is difficult:
- It takes 209 days on average to recruit a cardiologist even though they generate up to 7x their annual salary in revenue for hospitals.
Medicus offers some ideas on how to fix this, like:
- Advanced practice provider ratio expansions, which already increased 25% from 0.60 per cardiologist in 2020 to 0.75 in 2024.
- AI adoption in imaging analysis and clinical decision support.
- Locum tenens (temporary regional staffing, which Medicus provides) for coverage stabilization.
But the real, long term answer might not be AI or more APPs according to other industry giants like Johns Hopkins University; instead it’s making residency and fellowship training more accessible.
- For example the federal cap on Medicare-funded residency positions has remained largely unchanged since 1997.
- Furthermore, only 14% of residency slots are in rural locations.
The Takeaway
The cardiologist shortage is certainly going to get worse before it gets better. That said, Medicus’ analysis makes it clear that we need to overcome the inertia of opening more cardiology training opportunities while making it attractive for these physicians to practice in rural settings.
