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Cardiovascular Care for Hispanic Americans

Cardiovascular Care for Hispanic Americans

According to current estimates, more than 53 million Hispanics live in the United States, constituting about 17% of the total U.S. population. Hispanic Americans are the fastest-growing racial or ethnic population in the country and are expected to make up about 30% of the total population by 2050. “Hispanics are a diverse ethnic population, varying in race, origin, immigration status, and other socioeconomic factors,” says Carlos J. Rodriguez, MD, MPH. “The diversity among U.S. Hispanics presents many challenges.” Dr. Rodriguez says that Hispanics are a segment of the population that has been somewhat ignored in clinical research relating to cardiovascular disease (CVD). “We’re lacking comprehensive research data on the prevalence of risk factors for CVD among Hispanics,” he says. Only recently have national surveys started including more in-depth information pertaining to Hispanic Americans. Greater efforts have been made to specifically address CVD risk among U.S. Hispanics of late. This research has indicated that there is a sizeable burden of CVD risk factors among these individuals. More studies are still needed because Hispanics are the largest ethnic minority in the U.S. and are likely to significantly impact future healthcare costs. A Comprehensive Review There currently is no comprehensive resource about the cultural values and behavioral aspects that influence the promotion, prevention, and acceptance of heart health and treatment recommendations for Hispanics. To address some of the gaps in knowledge about the burden of CVD among Hispanics, the American Heart Association (AHA) released a scientific advisory on the status of CVD and stroke in Hispanic and Latino Americans. Published in Circulation, the document provides for the first time a comprehensive overview...

Appeals Court Strips Graduate of MD Degree

A three-judge panel of the US Court of Appeals for the Sixth Circuit reversed a federal district court decision and said that Case Western Reserve University could withhold an MD degree from a student who they said exhibited unprofessional behavior. I have written about this situation on two previous occasions—here and here. Briefly, a medical student who had performed well academically had committed a few transgressions outside the classroom. These included: sexually harassing some female students at a dance; attempting to avoid payment of a taxi fare; having problems interacting with staff, patients, and families, resulting in a failing grade and requirement to repeat a [sub?]internship; and asking faculty members not to mark him late for teaching sessions, which occurred 30% of the time. The issue that prompted the school to expel the student just prior to graduation was a conviction in another state for driving while intoxicated. He denied or had excuses for most of the incidents. The original court decision pointed out that his earlier problems had apparently not been considered serious because the school had given him positive letters of recommendation. The lower court also opined that professionalism was distinct from academic matters. The appeals court disagreed and said, “professionalism is part of what [medical] students must learn and practice.” It added that the school’s definition of professionalism in moral judgment terms was appropriate and should not be separated from academic performance. Here are some of the ways the school defined professionalism in its curriculum: ethical, honest, responsible and reliable behavior; respectful dialogue with peers, faculty, and patients, to enhance learning and resolve differences; recognize personal...
The Cardiology Workforce Supply

The Cardiology Workforce Supply

Previous workforce estimates implied that inadequate numbers of cardiologists were being trained to meet the needs of an expanding and older population of Americans. “There has been deep concern that a projected shortage in the cardiologist workforce could impact the care of patients with heart disease,” explains Patrick T. O’Gara, MD, FACC. “More recently, however, these forecasts have been called into question. Healthcare systems have shifted from volume-based care to value-based care. Both invasive and non-invasive procedural volumes have declined, as have the associated reimbursements. These trends have placed additional stress on providers and limited the hiring of newly graduating fellows, especially in geographically desirable locations.” A Multifaceted Problem Several factors are influencing the supply of cardiologists, including the aging and increasing population, the cost and duration of training, scientific advances, and the effects of the Affordable Care Act. There are also gender and racial/ethnic gaps in the cardiology workforce and geographic variations throughout the United States. Many cardiologists are practicing in major metropolitan areas, but there are fewer practicing in smaller towns and rural areas. “Many hospitals are rethinking how many cardiologists they need on staff, especially as they see their procedural volumes fall,” says Dr. O’Gara. “There is no longer the lack of invasively trained cardiologists as previously feared. It’s becoming more difficult for newly trained cardiologists to find attractive jobs. In addition, cardiologists are not retiring as rapidly as predicted.” Collaboration Needed to Find Solutions These problems affect all of cardiovascular medicine and are not easy to fix, according to Dr. O’Gara. “As a community, we need to ask where we’re going with the current training...
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