Outlook for cardiology over next 5 years

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Staffing challenges, patient demographic changes and new technology are among the top changes cardiologists expect to see in the field over the next five years.

Here, three cardiologists share their predictions for the industry:

Note: Responses have been lightly edited for length and clarity.

Joseph Messer, MD. Cardiologist at NorthShore University HealthSystem (Evanston, Ill.):

  1. Further industrialization of healthcare, leading to a handful of systems that control the industry, not unlike [how] Google, Twitter [and] Facebook now control information
  2. Progressive decline in physician income as increasing access overwhelms available funding
  3. Progressive increase in dependency on foreign medical graduates and female physicians to staff healthcare needs as U.S. males choose nonmedical careers
  4. Rapid growth of "geriatric cardiology" as patients with previously fatal conditions become chronically ill with controlled conditions such as heart failure, CAD, PAD, PHTN.
  5. Growth of the aging population and shrinking of the younger population will create generational stresses over funding of healthcare

Peter Rahko, MD. Professor of medicine at the University of Wisconsin School of Medicine and Public Health (Madison, Wis.): We will have a significant persistence of a lack of skilled nurses and skilled technicians that are vital to high-end medical care. One potential solution may be artificial intelligence, used not so much to replace these individuals, but to assist them in their workflow by streamlining repetitive tasks and performing computation tasks automatically. One would hope this could improve throughput in diagnostic imaging labs.

Kami Dinkel. CEO of Vascular Labs of the Rockies (Denver, Colo.): This is a very exciting time for cardiology, and I am very excited to see how the outpatient arena evolves over time. Technology growth within the cath lab has been massive over the last decade, allowing us to do more complex cases and fix conditions that we previously could not in the cath lab, which helps patients avoid risky surgical procedures, reduces recovery time and reduces complications. The move from femoral access to radial and dorsalis pedis for endovascular cases has had a major impact alone, giving us new access sites that have less risk and potential complications, which allows hospitals to do same-day procedures, thus precipitating this initial shift of coronary procedures safely into the outpatient setting.

I predict that as more cardiovascular ASCs open across the U.S. and prove that these cases are not only safe and cost-effective but a preferred environment by the patients, outpatient centers will become the preferred site for nonacute cardiac and vascular care. I believe vendors will support further technology to help support the outpatient centers to increase what we are able to do safely in the outpatient setting, allowing further expansion of appropriate procedures. I believe that referring providers, payers and patients will see and understand the value these centers provide, increasing payer alignments and patients' requests for such centers. I believe that there will be expansion of inclusion criteria of allowable coronary interventional procedures (it is very limited right now) as well as the addition of EP procedures in the ASC setting as well.

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