What's missing in cardiology conversations

From preparing for the effects of AI to bracing for the "silver tsunami," here is what cardiology leaders who shared their insights with Becker's said should be prominent topics of conversation in the industry.

Question: What are cardiology leaders not talking about enough?

Editor's note: Responses have been lightly edited for clarity and length.

Eldrin Lewis, MD. Chief of the Division of Cardiovascular Medicine at Stanford (Calif.) Medicine: Therapies that impact cardiovascular morbidity and mortality continue to expand, but at a relatively high price tag. Making these interventions affordable will translate into better outcomes. Not addressing affordability will likely lead to a widening disparity between those with and without. 

A recent study suggested that 47% of counties in the United States do not have a single cardiologist. The infrastructure required to provide innovative care is often not found in some of these counties. We need to have an emergency response team that can link patients who live in rural areas to centers that can provide definitive care. A national stroke response system is imperative as well given the short time before permanent disability occurs in the setting of acute strokes.  

The integration of genomics and gene-based therapies to provide precision cardiovascular medicine to our patients needs to be further developed. We need to learn from our oncologist colleagues who are using innovative cellular based therapies targeting cancers.  

We need to talk about AI-assisted care delivery, wearable technology, and patient reported outcomes. We also need to be at the forefront and training everyone in hands-only CPR given the fact that the survival rate for out of hospital cardiac arrest remains dismally low.  

Finally, our goal should be to improve how long people with cardiovascular disease live but also how well they live. This requires no cost instruments to measure patient reported outcomes in clinical practice and integration of these data into medical decision-making.

Patrick McCarthy, MD. Executive Director of the Northwestern Medicine Bluhm Cardiovascular Institute (Chicago): Many talk in very vague and general terms about AI in medicine but not specifically about how it may impact our day-to-day patient care in a few years. This can involve large language models summarizing complex patient charts; AI overreading cardiac catheterization, echocardiogram and other images; and AI suggesting diagnoses and treatments. While we are starting to see these introduced, the implications for early career cardiologists will become profound.

Gordon Wesley. Vice President of the AdventHealth Heart, Lung and Vascular Institute (Orlando, Fla.): We should talk about the "silver tsunami" that's coming. By 2030, all the baby boomers will be of an age where they need cardiology care and we don't have enough cardiologists. When fellows finish, they often specialize in areas like electrophysiology, structural heart or advanced heart failure, which means we have fewer general cardiologists. And yet we need general cardiologists to serve our communities. This creates a conflict between procedural excellence and patient access. How do we solve that? 

That's where advanced practice providers, 24/7 remote patient monitoring and virtual care come in. We need to improve access, because chronic conditions don't wait. Cardiologists are in short supply and recruiting them is tough. We need to be smarter about leveraging the talent we have, like APPs and other innovations, to meet the growing demand.

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