Cardiovascular Business caught up with a few healthcare executives at the Transcatheter Cardiovascular Therapeutics (TCT) 2022 meeting in Boston and asked them all the same question: What are some of the biggest challenges impacting today’s cardiologists?
Three of the executives were once cardiologists themselves, and the other is a longtime veteran of the industry, so each person was able to share a fascinating bit of insight into how the industry’s largest companies view the current healthcare landscape. Read their full answers below:
1. Ian Meredith, AM, executive vice president and global chief medical officer for Boston Scientific
Managing the cost of healthcare, first of all, is a big challenge. We’re all aging, and the population is growing dramatically. It’s going to continue growing. By 2040, we’ll be close to 10 billion people on this planet. So many of our aging population is going to be at risk of cardiovascular disease—how do we manage all of those patients? How do physicians prepare for that? How can we diagnose illnesses more early so that acute care isn’t so transactional? There are a lot of challenges related to that population growth.
Today’s physicians have to take a really broad view of how we’re going to manage these health problems going forward. It’s something we wrestle with a lot, how to play a meaningful role and address all of these problems. There’s no point in just being able to treat the top 1% of the world’s population. We have to be able to diagnose a large number of patients early and provide them with safe, simple treatments.
In addition, today’s cardiologists encounter so much information and so many devices. Making sense of all of this data analysis and all of these new devices is another challenge in healthcare.
Of course, so many people leaving the workforce altogether during and after the COVID-19 pandemic has not helped things in the short term either. Maybe it will help us focus more on efficient, out-of-hospital solutions to some of these problems in the future.
2. Jeffrey Popma, MD, vice president and chief medical officer for Medtronic’s structural heart, aortic, coronary and renal denervation operating units
Time management is one challenge. There are an increasing number of patients requiring care, and the patients are more complex that previously seen. Physicians often try to balance time and quality/personal care for their patients. Physician extenders have helped with these issues, but tend to put distance between the patient and the clinicians.
Another challenge is keeping up with the latest research. This means physicians have an additional time commitment to stay up to date with new data and how it might inform their approach to patient care
A third challenge for cardiologists is burnout. Those other issues I mentioned often leave physicians stressed and overwhelmed, which can lead to a higher risk of burnout. Pre-approvals required by third-party payers may cause tensions, for example, and the conflict between administrative insurance guidelines for clinical testing and the need for patient-based medical care does not help. Physician burnout has been exacerbated by the COVID-19 pandemic and the ongoing staff shortages we’re seeing right now.
3. Nick West, MD, chief medical officer and divisional vice president of global medical affairs for Abbott’s vascular business
Cardiologists in the field are still trying to recover from the long-term effects of the pandemic. They don’t have enough staff, and their hospitals are still struggling with revenue. Vendors are even seeing the same issues, because fewer procedures leads to fewer devices are being used, etc.
Interestingly, it’s not just COVID-19 that is making an impact—there’s also been this ongoing physician shortage that was present before the pandemic. And this is a worldwide problem, by the way, it’s not just the United States. People are thinking, ‘I don’t want to do this anymore. I need to do something else.’ That’s happening everywhere right now. Abbott and other vendors, we don’t have the answer to that problem—but we are doing our best to make solutions that are more efficient and may not require as much heavy lifting from physicians.
Cardiologists are also struggling to reach patients. There is poor access to healthcare among a lot of patients, especially those in underserved communities and women. The women we heard from have more difficulties finding doctors they trust and more difficulties sticking with the same doctor. We don’t fully know yet how to address those issues, but the awareness is important.
Communication can also be very poor in our healthcare systems. Primary care physicians may not get the information they need from a specialist, one specialist may not communicate with another specialist—and then the patient is expected to carry all of that baggage around, it weighs them down. We have electronic health records, of course, but they are not yet unified. All of these communication issues lead to low satisfaction, which leads to poor reviews for these hospitals and health systems.
4. Chris Landon, senior vice president and general manager of image-guided therapies for Philips
The thing we hear the most about from physicians is getting after those more complex patients, the ones where the solution to their problem isn’t the most obvious. I was just talking to a physician last night about cardiogenic shock patients, in fact, and how there just aren’t a lot of guidelines yet focused on treating that challenging patient population. Those complex patient populations that are hard to manage are the ones we hope we can serve in the long run with data-driven and ‘smart’ technologies.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.