Health
No cardiologists available in half of US counties as study reveals ‘incredibly concerning’ care gaps
Nearly half of all U.S. counties don’t have a practicing cardiologist on staff, according to a recent study published in the Journal of the American College of Cardiology (JACC).
Rural communities are most affected, with Americans in those areas dying earlier and more often from heart disease that could have been prevented, according to a May report from the Centers for Disease Control and Prevention (CDC).
The study, led by Brigham and Women’s Hospital in Boston, analyzed over 3,100 counties.
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Forty-six percent of the counties did not have access to cardiologists — meaning that 22 million residents would not have access to heart-related health care.
When looking just at rural counties, more than 86% of them did not have a cardiologist.
Nearly half of all U.S. counties don’t have a practicing cardiologist on staff, according to a recent study published in the Journal of the American College of Cardiology. (iStock)
“While cardiologists are not the only determinants of cardiovascular outcomes, the lack of access to cardiologists in areas with greater prevalence of heart disease and mortality is incredibly concerning,” said senior author Haider J. Warraich, M.D., director of the heart failure program at VA Boston Healthcare and an associate physician at Brigham and Women’s Hospital, in a press release.
How does this impact patients?
In counties without a cardiologist, patients have to travel an average of 87.1 miles to get the care they need, the study found.
“When a patient is having a heart attack, time matters,” said Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution, a Cincinnati-based company that offers cardiovascular and anesthesiology services to hospitals nationwide.
In the counties without a cardiologist, patients have to travel an average of 87.1 miles to get the care they need, the study found. (iStock)
“If a patient is unlucky enough to have a heart attack in a rural area, without cardiology services, they are sometimes transferred via ambulance or helicopter, but this takes time while the heart is dying.”
In some cases, these patients receive high-risk medications called thrombolytics to help stop the heart attack, according to Serwer, who was not involved in the new study.
“Thrombolytics are an inferior option to treat heart attacks compared to primary percutaneous coronary intervention (PCI), also known as stenting,” Serwer said.
“When a patient is having a heart attack, time matters.”
“Thrombolytics are a last resort when transfers are not possible or will take too long, as they are still better than the alternatives.”
Patients in rural counties have a higher age-adjusted cardiovascular mortality rate — on average, they live one year less than their urban cohorts, according to Serwer.
Why the lack of cardiologists?
Several factors may contribute to the scarcity of heart specialists in rural areas, according to Serwer.
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“Cardiologists train in academic hospitals with a wide network of colleagues, specialists and sub-specialists,” he told Fox News Digital.
“When they finish training, many of them want to join a large group practice or hospital practice, as there is comfort working alongside other cardiologists who can provide mentorship and guidance, especially early in one’s career.”
“These deficiencies cause a delay in care and can mean the difference between life and death,” a cardiologist said. (iStock)
Many cardiologists are unwilling to leave an urban environment to move to a remote location, he noted, particularly if they have children who need access to more schooling options.
Cardiologists in rural areas are also more likely to be overworked, Serwer said, due to the fact that the community may only have one or two heart specialists. Often, the community doesn’t have subspecialists such as CT surgeons, electrophysiologists or interventional cardiologists.
“These factors ultimately lead to less time with the family and an unfavorable work/life balance,” the cardiologist said.
Another challenge is that rural facilities require a complex system to transfer patients for a higher level of care, he went on.
“Inpatient and critical care beds at tertiary medical centers are hard to find,” Serwer said. “These deficiencies cause a delay in care and can mean the difference between life and death, which takes an emotional toll on rural health care providers.”
“Understand the importance of cardiac risk factor modification with healthy lifestyle, exercise, diet and medication compliance,” a cardiologist advised. (iStock)
There are also reimbursement considerations, as many rural hospitals don’t have the financial ability to pay their doctors adequately, according to Serwer.
There is also a great need for anesthesiologists in rural counties, he added.
“Nearly every hospital procedure requires an anesthesiologist, whether it’s cardiology, OB, orthopedics or general surgery.”
What needs to happen?
Solving the rural health care dilemma should start with greater awareness and a better understanding of the issues and limitations, according to Serwer.
One option is to set up “creative staffing models” to cover more parts of the country.”
“We need to reduce the hurdles and increase the incentive for physicians, nurses, technologists and administrators to provide rural health care,” he told Fox News Digital.
One option is to set up “creative staffing models” to cover more parts of the country, said Serwer.
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His company, VitalSolution, partners with rural facilities to provide long-term coverage for cardiologists, nurse anesthetists, nurses and cath lab technicians.
“Our physicians work seven days on and then get seven days off,” he said.
“This unique model allows our physicians to work where they are needed and live wherever they want — it’s a win/win for physicians and community hospitals.”
Technology-based clinical support — such as telemedicine — should also be used on a wider basis, a cardiologist recommended. (iStock)
Technology-based clinical support — such as telemedicine — should also be used on a wider basis, Serwer recommended.
“We also need more governmental financial support for rural community hospitals and incentives for physicians, nurses, technologists and administrators,” he said.
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Another option is to promote rural health care while in medical school by requiring rotations in those communities, the cardiologist said.
“These rural rotations can be very rewarding, and can help young physicians gain a more comprehensive understanding of the practice of medicine.”
“Establish a relationship with a primary care provider and know more about your chronic medical conditions,” a doctor advised. (iStock)
The study researchers also called for policy changes to expand internet availability for telemedicine access and to broaden health insurance coverage.
Managing modifiable risk factors for heart disease could also help to reduce risk in rural communities, they stated.
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“This study underscores the urgent need for policy reforms and innovative solutions, such as financial incentives for clinicians and the expanded use of telemedicine, to bridge this gap,” said Harlan M. Krumholz, M.D., editor-in-chief of JACC, in the release.
“Ensuring equitable access to cardiovascular care is a crucial step toward improving overall public health outcomes and reducing preventable cardiovascular mortality.”
Short-term fixes
For patients who are currently living in one of the cardiac care “deserts,” Serwer recommended becoming familiar with the medical care that is available.
“Establish a relationship with a primary care provider and know more about your chronic medical conditions,” he advised.
“Understand the importance of cardiac risk factor modification with healthy lifestyle, exercise, diet and medication compliance,” he also said.
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Those who have a cardiac condition should make a plan of where and how to seek cardiac care if needed, the doctor said.
“They can also write to their elected officials to ask them to do more to supplement the existing health care infrastructure,” Serwer added.
Health
‘Weight Loss Has Never Been About Calories’: How This Low-Insulin Diet Helped Lillie, 58, Drop 70 Lbs!
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Big moves are continuing in the weight loss landscape in the new year following breakthrough research of GLP-1 medications and other methods.
Weight-loss experts spoke with Fox News Digital about their predictions for the most major changes to come in 2026.
No. 1: Shift to whole-body treatment
Dr. Peter Balazs, a hormone and weight loss specialist in New York and New Jersey, shared that the most important shift is likely to label GLP-1 drugs as “multi-system metabolic modulators” rather than “simple weight loss drugs.”
MORE AMERICANS MAY BE CLASSIFIED AS OBESE UNDER NEW DEFINITION, STUDY SUGGESTS
“The treatment goal is no longer just BMI reduction, but total cardiometabolic risk mitigation, with effects now documented across the liver, heart, kidneys and vasculature,” he said.
“We are seeing a significant reduction in major adverse cardiovascular events … and progression of renal disease,” he went on.
The focus of GLP-1 drugs will widen beyond weight loss and diabetes, according to experts’ predictions. (iStock)
Philip Rabito, M.D., a specialist in endocrinology, weight loss and wellness in New York City, also shared that “exciting” advancements lie ahead for weight-loss drugs, including GLP-1s and GIPs.
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“These next‑generation agents, along with novel combinations that include glucagon and amylin agonists, are demonstrating even more impressive weight‑loss outcomes than currently available therapies, with the potential for better tolerability and sustained results,” he told Fox News Digital.
“There is also tremendous optimism around new federal agreements with manufacturers that aim to make these medications more widely accessible and affordable for the broad population of patients who need them most.”
No. 2: More convenient dosing
The typical prescription for a GLP-1 medication is a weekly injection, but delivery and dosing may be changing to more convenient methods in 2026, according to Balazs.
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A daily 25 mg pill version of Novo Nordisk’s Wegovy, a semaglutide designed to treat obesity, is now approved and available for chronic weight management, offering a non-injectable option for some patients.
A once-weekly oral GLP-1 is currently in phase 2 trials, as well as an implant that aims for three to six months of drug delivery, Balazs noted.
Incisionless weight-loss procedures will rise as a lower-risk option, according to experts. (iStock)
No. 3: Less invasive surgery
In addition to decreased risk during surgery for GLP-1 users, Balazs also predicted that metabolic surgery without incision will rise as a better option.
“Incisionless endoscopic procedures — like endoscopic sleeve gastroplasty (non-surgical weight-loss procedure that makes the stomach smaller from the inside) and duodenal mucosal resurfacing (non-surgical procedure that resets part of the small intestine to help the body better handle blood sugar) — [may become] more durable and widely available,” he said.
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“These offer significant metabolic benefits with shorter recovery and lower risk than traditional surgery.”
Rabito agreed that “rapid progress” in minimally invasive weight‑loss procedures is “opening powerful new options for patients who are hesitant to pursue traditional bariatric surgery.”
Bariatric surgery remains the most effective weight loss method, one specialist says. (iStock)
This avenue offers “meaningful and durable weight reduction with less risk, shorter recovery times and no external incisions,” the expert added.
Dr. Muhammad Ghanem, bariatric surgeon at the Orlando Health Weight Loss & Bariatric Surgery Institute, reiterated that surgery remains “the most successful modality for the treatment of obesity … with the highest weight loss and most durable outcomes as of yet.”
No. 4: Younger GLP-1 users
As Novo Nordisk’s Wegovy has been indicated for adolescents over 12 years old as an obesity treatment, Balazs commented that pediatric use of weight-loss drugs is “now a clinical reality.”
He predicted that other alternatives are likely to be approved in 2026 for younger users.
No. 5: High-tech, personalized access
Amid the growth of artificial intelligence, Balazs predicted an expansion in the clinical implementation of AI-driven weight-loss methods.
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This could include categorizing obesity into sub-types like “hungry brain,” “emotional hunger” and “slow burn” to personalize how therapy is prescribed while moving away from “trial and error,” he said.
Ghanem agreed that there will likely be a “big focus” on individualized testing for causes of obesity in 2026, as it’s a disease that can have “different causes in different people,” thus requiring different treatments.
AI and other digital opportunities will drive more access for weight-loss patients, experts say. (iStock)
The doctor anticipates that more patients will seek combinations of comprehensive treatments and programs.
“Patients are more aware that now we have a few weapons in our arsenal to combat obesity, and [they] are seeking a multidisciplinary and holistic approach,” Ghanem said.
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Treatment options will also turn digital with the rise of prescription digital therapeutics (PDTs) for weight loss, Balazs predicted.
“These are software applications delivering cognitive behavioral therapy, personalized nutrition and metabolic coaching through algorithms, often integrated with continuous glucose monitors, and reimbursed as medical treatments,” he said.
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Ghanem added that body composition analyzers, like DEXA scans, will likely be more widely used as awareness grows about the limitations of BMI and weight in assessing obesity.
Congratulations, you’ve reached the final day of the Brain Health Challenge! Today, we’re asking you to do a few things that might feel a bit out of left field — like getting your blood pressure checked.
No, it isn’t as fun as playing Pips, but experts say it’s one of the most important things you can do for your brain. That’s because heart health and brain health are intrinsically linked.
High blood pressure, in particular, can damage brain cells, and it’s a significant risk factor for stroke and dementia. When blood pressure is too high, it places stress on the walls of arteries in the brain. Over time, that added stress can cause the blood vessel walls to thicken, obstructing blood flow. In other cases, the increased pressure causes the artery walls to thin and leak blood into the brain.
These changes to the blood vessels can sometimes cause a large stroke to occur. More commonly, the damage leads to micro-strokes and micro-hemorrhages, which cause fewer immediate problems and often go unnoticed. But if someone has hypertension for years or decades, these injuries can build up, and the person may start to experience cognitive impairment.
High blood pressure “is known as a silent killer for lots of reasons,” said Dr. Shyam Prabhakaran, the chair of neurology at the University of Chicago. “It doesn’t cause you any symptoms until it does.”
Because the damage accumulates over many years, experts say that managing blood pressure in midlife matters most for brain health. Hypertension can be addressed with medication or lifestyle changes, as directed by your doctor. But the first thing you need to do is know your numbers. If your blood pressure comes back higher than 120/80, it’s important to take it seriously, Dr. Prabhakaran said.
While you’re at it, there are a few other aspects of your physical health that you should check on.
Your eyes and ears are two of them. Hearing and vision loss have both been shown to increase the risk of dementia. Experts think that with less sensory information coming in to stimulate the brain, the regions that process hearing and vision can start to atrophy. What’s more, people with sensory loss often withdraw or are left out of social interactions, further depriving them of cognitive stimulation.
Oral health can also affect your brain health. Research has found a connection between regular flossing and reduced odds of having a stroke. That may be because good oral health can help to reduce inflammation in the body. The bacteria that cause gum disease have also been tied to an increased risk of Alzheimer’s.
And have you gotten your shingles vaccine? There is mounting evidence that it’s a powerful weapon for protecting against dementia. One study found that it lowered people’s odds of developing the condition by as much as 20 percent.
To wrap up this challenge, we want you to schedule a few medical appointments that benefit your brain, as well as your body.
After five days of feeding, exercising and challenging your brain, you are well on your way to better cognitive health. Thanks for joining me this week, and keep up the good habits!
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