Cardiologists are navigating one of the most turbulent periods in modern medicine. As reimbursement tightens and administrative burdens mount, many heart specialists are struggling to balance patient care, financial pressure and their own well-being.
Here are five trends keeping cardiologists up:
1. The sting of reimbursement cuts
The Centers for Medicare & Medicaid Services’ 2025 physician fee schedule included a 2.83% pay cut, sparking frustration among cardiologists who say they can’t keep absorbing reductions while operating costs climb.
“Unlike any of our other colleagues within the healthcare economic system who always get increases, the physician schedule just continues to get hammered,” Cathleen Biga, MSN, of Cardiovascular Management of Illinois in Woodridge, told Becker’s. “And yet our costs are very similar to our hospital colleagues: labor costs, postpandemic supply costs, real estate costs; and the complexity of our patients within the outpatient ambulatory setting just continue to escalate.”
2. Demand outstripping compensation
Average cardiologist pay fell by about 4% from about $525,000 in 2023 to $506,000 in 2024, even as patient volumes and workloads continued to grow. A majority of cardiologists — 56% — believe physicians are unfairly compensated for the value they deliver.
3. Burnout’s threat to access
Seventeen percent of cardiologists said their burnout was so severe that they were considering leaving medicine, while only 3% said burnout didn’t affect their life in Medscape’s 2024 Cardiologist Burnout & Depression Report. The top contributors driving burnout included too many bureaucratic tasks (69%), long hours (43%) and lack of respect from administrators or colleagues (40%). Nearly half said adding support staff or increasing physician autonomy would help most, while 67% said burnout has affected their personal relationships.
4. Strain on independent practice
Cardiology is undergoing sweeping consolidation, driven by private equity and structural shifts in physician employment. The number of PE-backed cardiology platforms has more than doubled since 2022, now spanning nearly 20 states — with heavy activity in Florida and Texas. More than 70% of cardiologists are now employed by hospitals or large health systems, while nearly half of private practices are part of a PE portfolio.
5. Mounting pressures on all fronts
Cardiologists say the combined squeeze of rising patient complexity, medication costs and red tape are making it harder to deliver timely care, while payers are increasingly denying vascular procedures for high-risk patients.“Private practice has eroded,” Rajesh Sharma, MD, of Advanced Heart and Vein Center in Thornton, Colo., told Becker’s, “and I feel that now there may be a migration back to private practice to provide more timely and cost-effective cardiac care.”
