Gregory Mishkel, MD, division head of cardiology, co-director of the cardiovascular institute and vice president of cardiology operations at Evanston, Ill.-based NorthShore University HealthSystem, discussed the cardiology workforce, where cardiovascular surgery is headed and more during a recent episode of the Becker's Healthcare cardiology podcast.
Here is an excerpt from the podcast. Click here to download the full episode.
Editor's note: This response was lightly edited for length and clarity.
Question: What are you excited about today in cardiology, and what makes you nervous?
Dr. Gregory Mishkel: There's a long list of things that get you excited when you read about them. Sometimes they're solutions for problems right now, but certainly: understanding the expanding role of artificial intelligence; the use of personalized genomics; and translating what you learn about a patient's genome to their own personalized care plan. You think about all of the possibilities that could be associated with 3D printing and robotics.
The things that make me nervous are really more people-related — not technology-related — such as the fact that we see a shrinking cardiovascular surgery volume. It makes me nervous because the folks who are coming out of training have done less procedures. They potentially are not as adept as the senior partners who do cardiovascular surgery once were when they came out of training, and there's less surgery for them to do. And there are less job opportunities.
It really does concern me that our ability to provide cardiovascular surgery could be seriously degraded over time. As an analog to that, I also think about my own division of some 60 to 70 cardiologists. The average age of our division is in the 50s. And we have a very substantial population of cardiologists well into their 60s. In fact, the oldest member of my division, who is still practicing, is 90, and that's laudable. But what you realize is that there are going to be a significant number of retirements over the next several years. How do we replace those cardiologists? Do we have a sufficient fellowship pool? Do we have a sufficient number of people being trained to handle the increasing demands of cardiology? I am fearful that we may not have as robust a supply of cardiologists as we potentially will need in the near future.