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No cardiologists available in half of US counties as study reveals ‘incredibly concerning’ care gaps

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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.

TOP 10 CAUSES OF DEATH IN THE US, SEE THE CDC’S LATEST LIST

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.

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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.

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Doctor taking blood pressure

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.”

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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.

HUNDREDS OF RURAL HOSPITALS ARE IN DANGER OF SHUTTING DOWN, STUDY FINDS: ‘AT RISK OF CLOSURE’

“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.”

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“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.”

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“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.”

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“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.

HEALTH CARE IS ‘OVERWHELMINGLY COMPLEX’ FOR OLDER ADULTS, EXPERTS SAY: ‘EVER-INCREASING HURDLE’

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.

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“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.”

Senior couple telehealth

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. 

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“These rural rotations can be very rewarding, and can help young physicians gain a more comprehensive understanding of the practice of medicine.”

Woman heart doctor

“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. 

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“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.

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First at-home syphilis antibody test gets FDA authorization as STD cases spike in US

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First at-home syphilis antibody test gets FDA authorization as STD cases spike in US

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The U.S. Food and Drug Administration has granted marketing authorization for the first at-home syphilis test.

The over-the-counter First To Know Syphilis Test, made by NOWDiagnostics in Arkansas, detects antibodies for Treponema pallidum (syphilis), according to a press release.

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The test, which does not require a prescription, takes about 15 minutes to administer using only a drop of blood — “like a finger prick,” the company said.

AS SYPHILIS CASES SURGE IN THE US, HERE’S WHAT INFECTIOUS DISEASE EXPERTS WANT YOU TO KNOW

Results will be positive for those experiencing a current syphilis infection — as well as for those who have been previously diagnosed, even if they were successfully treated.

The test results are not sufficient to diagnose syphilis alone, however, and should be followed by additional testing from a provider to confirm the diagnosis, according to the FDA.

The First To Know Syphilis Test, pictured here, uses a blood sample to detect the infection. (NOWDx)

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A clinical study of 1,270 people found the product “easy to use,” a press release from NOWDiagnostics noted.

The study results showed that the test correctly identified 99.5% of negative results and 93.4% of positive diagnoses.

TEXAS CITY REPORTS SYPHILIS OUTBREAK AMID ‘LIMITED SUPPLY’ OF PENICILLIN DRUG

“With FDA authorization now granted, we are proud to offer the first test of its kind that provides highly accurate results in just minutes, using a single drop of blood and without the need for a buffer,” NOWDiagnostics CEO Rob Weigle told Fox News Digital via email. 

“This breakthrough in diagnostic testing empowers individuals to take control of their health from the privacy of their own home, playing a critical role in early detection and treatment, and ultimately helping to slow the spread of syphilis and protect public health.”

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First To Know Syphilis Test Box

“This is a great advance and has been vetted for accuracy,” one doctor commented. (NOWDx)

Fox News medical contributor Dr. Nicole Saphier said she considers at-home tests to be “great,” as they often lead to more people being tested who would not otherwise visit the doctor.

“Anything that increases access to health information while also being cost-effective is a positive step in the right direction,” the New York-based doctor told Fox News Digital.

Efforts to stop the surge

There has been a major rise in syphilis cases in the U.S. over the last few years.

Cases spiked by 80% between 2018 and 2022, according to data from the Centers for Disease Control and Prevention (CDC).

SYPHILIS CASES SURGE IN THE US, REACHING LEVELS UNSEEN SINCE 1950

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In 2022, more than 3,700 cases of congenital syphilis were reported among newborns, the agency stated.

Earlier this year, the Department of Health and Human Services established the National Syphilis and Congenital Syphilis Syndemic (NSCSS) Federal Task Force to help combat the surging numbers.

split image of syphilis bacteria and at home test

Study results showed that the test correctly identified 99.5% of negative results and 93.4% of positive diagnoses. (iStock; NOWDx)

In addition to the task force, the FDA assured that the authorization of this new at-home test will help to “reverse the recent dramatic rise of STIs in the United States.”

“If left untreated, syphilis can seriously damage the heart and brain and can cause blindness, deafness and paralysis,” the FDA wrote in the press release. 

HAWAII HEALTH OFFICIALS CALL FOR ACTION AS SYPHILIS CASES RISE

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“When transmitted during pregnancy, it can cause miscarriage, lifelong medical issues and infant death.”

Fox News senior medical analyst Dr. Marc Siegel told Fox News Digital that these advancements could also play into the CDC’s new program, DOXY PEP, which aims to prevent “post-exposure prophylaxis with doxycycline for chlamydia, gonorrhea and syphilis.”

“When transmitted during pregnancy, [syphilis] can cause miscarriage, lifelong medical issues and infant death.”

The program has been shown to “markedly decrease clinical infection,” said New York-based Siegel.

Siegel called the new syphilis test “especially important,” as “the earlier syphilis exposure/diagnosis is made the better.”

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Blood sample positive with syphilis

The authorization of the new at-home test will help to “reverse the recent dramatic rise of STIs in the United States,” the FDA stated. (iStock)

Michelle Tarver, M.D., PhD, acting director of the FDA’s Center for Devices and Radiological Health, wrote in a statement that advancements in tests for STIs can “give patients more information about their health from the privacy of their own home.” 

“Access to home tests may help increase initial screening for syphilis, including in individuals who may be reluctant to see their health care provider about possible sexually transmitted infection exposure,” she said.

HOUSTON HEALTH OFFICIALS REPORT SYPHILIS OUTBREAK, 128% SPIKE IN CASES AMONG WOMEN

This can lead to increased lab testing to confirm the diagnosis, Tarver added, which can increase treatment and help curb the spread.

Man having appointment with specialist in clinic

The FDA confirmed that false negative results may occur, which can cause delays in treatment and further spread of the infection. (iStock)

Saphier added that as syphilis cases rise, it’s “disappointing to see so many advanced cases of a disease that is otherwise treatable.” 

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“While prevention is always the best method, early detection and treatment intervention are essential to not only result in the best health outcome, but also decrease the overall cost burden on society — because advanced disease and disability are expensive,” she said. 

Potential limitations

Saphier shared some concerns about using at-home tests in detecting illness, as they are “often lower in accuracy than standardized laboratory testing.”

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“This may result in false negative results and a person who otherwise may require treatment not seeking it,” she said. 

“If someone is [at] high risk for syphilis exposure or having symptoms, they should skip the at-home testing and speak to their doctor.”

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The FDA confirmed that false negative results may occur, which could cause delays in treatment.

Illustration of syphilis bacterium

Congenital syphilis symptoms include sores and rashes on the skin, fever, jaundice, sneezing or runny nose and swollen spleen and liver, according to Mayo Clinic. (iStock)

“Results of the test alone should not be used to start, stop or change any treatments without a health care provider,” the FDA wrote in the press release.

“If someone is [at] high risk for syphilis exposure or having symptoms, they should skip the at-home testing and speak to their doctor.”

“In addition, individuals using this test who may have been recently exposed to syphilis should seek care from a health care provider for treatment and evaluation regardless of this test’s results.”

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Congenital syphilis symptoms include sores and rashes on the skin, fever, jaundice, sneezing or runny nose, and swollen spleen and liver, according to Mayo Clinic’s website.

If left untreated, later symptoms can include hearing loss, dental problems and “saddle nose,” a condition in which the bridge of the nose collapses.

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Best HIIT Workout for Women: 10 Minutes Every Other Day Boosts Endurance and Helps With Weight Loss

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Best HIIT Workout for Women: 10 Minutes Every Other Day Boosts Endurance and Helps With Weight Loss


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Dementia has 2 shocking new risk factors, study finds, with total of 14 now on list

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Dementia has 2 shocking new risk factors, study finds, with total of 14 now on list

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Two surprising new risk factors for Alzheimer’s disease are noted in a new study.

Untreated vision loss and high levels of LDL cholesterol have been linked to a greater chance of developing the common dementia type.

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Low-density lipoprotein (LDL), which is sometimes called “bad cholesterol,” is associated with negative health effects when present in high amounts. 

HIGH BLOOD PRESSURE AND ALZHEIMER’S DISEASE COULD GO HAND IN HAND, STUDY FINDS

Researchers from University College London led the study, published in The Lancet on Aug. 10.

The findings were also presented at the Alzheimer’s Association International Conference (AAIC) in Philadelphia on July 31.

Untreated vision loss and high levels of LDL cholesterol have been linked to a greater chance of developing Alzheimer’s. (iStock)

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Vision loss and high LDL cholesterol join a list of 12 other risk factors the researchers previously identified in 2020.

Those 12 are hearing loss, lower education, smoking, hypertension, obesity, physical inactivity, depression, diabetes, excessive alcohol consumption, air pollution, traumatic brain injury and social isolation.

AI FAST-TRACKS DEMENTIA DIAGNOSES BY TAPPING INTO ‘HIDDEN INFORMATION’ IN BRAIN WAVES

To identify the two new risk factors, the researchers analyzed dozens of recent studies on vision loss and high cholesterol.

The 14 total factors are responsible for roughly half of dementia cases globally, the researchers stated, which means eliminating them could potentially prevent many cases.

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Amyloid beta

About half of all Alzheimer’s cases can be attributed to 14 total factors, the researchers stated. (iStock)

“Some dementia risk factors, such as alcohol consumption and physical exercise, can be managed by changing your lifestyle, but many must be addressed on a societal level,” Fiona Carragher, chief policy and research officer at the Alzheimer’s Society in the U.K., said in a press release. 

(The study was partly funded by the Alzheimer’s Society.)

“Social isolation, education inequalities and air pollution are beyond individuals’ control and require public health interventions and joint action between government and industry.”

“I tell patients all the time, ‘if it’s healthy for the heart, it’s healthy for the brain.’”

Dr. Earnest Lee Murray, a board-certified neurologist at Jackson-Madison County General Hospital in Jackson, Tennessee, was not involved in the study but said it “substantiates a lot of things we have known about dementia for several years.”

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He told Fox News Digital, “The study in Lancet shows higher levels of LDL (the bad cholesterol) — which is often related to diet and lifestyle choices — is related to a greater chance of developing a dementia process.”

To prevent vision loss, the U.S. Centers for Disease Control and Prevention (CDC) recommends getting regular eye exams.

To prevent vision loss, the U.S. Centers for Disease Control and Prevention (CDC) recommends getting regular eye exams. (iStock)

“Genetic factors can play a role in elevated levels of LDL — however, even in these patients, diet modifications can be beneficial as well.”

The neurologist was also not surprised by the link between vision loss and development of dementia. 

ALZHEIMER’S AND PARKINSON’S RISK IS HIGHER FOR PEOPLE WITH BODY FAT IN TWO SPECIFIC AREAS

“We have known for years that patients who have higher levels of education and are ‘well-read’ often develop dementia at a much later age,” Murray said. 

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“We rely heavily upon eyesight to be able to engage in our surroundings as well as stimulate cognitive thought.” 

Reducing the risk

In his practice, Murray said, he is often asked about ways to prevent or reduce the risk of developing dementia at a later age. 

“Patients have a good understanding of what a heart-healthy diet and lifestyle look like,” he told Fox News Digital. 

LDL cholesterol

Low-density lipoprotein (LDL), which is sometimes called “bad cholesterol,” is associated with negative health effects when present in high amounts.  (iStock)

The brain is a “very vascular organ,” the doctor pointed out — which means it is closely linked to the heart.

“I tell patients all the time, ‘If it’s healthy for the heart, it’s healthy for the brain,’” Murray said.

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ALZHEIMER’S BLOOD TEST DETECTS DISEASE WITH 90% ACCURACY IN ROUTINE DOCTORS’ APPOINTMENTS: STUDY

“This not only includes dietary changes, such as lower fat/lower cholesterol diets, but also lifestyle modifications, such as smoking and alcohol cessation.”

There is also evidence that the Mediterranean diet can be beneficial in delaying the onset of dementia, Murray noted. 

Man exercising

“Regular exercise is beneficial from a vascular standpoint, and can also help from a mental standpoint,” a neurologist said. (iStock)

“Regular exercise is beneficial from a vascular standpoint, and can also help from a mental standpoint,” he added.

Participating in cognitively stimulating activities is also known to delay the potential onset of dementia, according to Murray.

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“I tell my patients to find some cognitively challenging activity they enjoy, whether that’s working puzzles or reading challenging books,” he said. 

“These activities can maintain a higher level of cognitive abilities and retard the onset of dementia.”

Fresh vegetables

Eating a diet rich in fruits and vegetables can help to protect vision and promote heart health, doctors say. (iStock)

To prevent vision loss, the U.S. Centers for Disease Control and Prevention (CDC) recommends getting regular eye exams, wearing protective eye wear in high-risk environments and wearing sunglasses to prevent exposure to UV rays.

      

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Knowing your family’s eye health history, eating a diet rich in fruits and vegetables, maintaining healthy blood sugar levels and avoiding smoking can also prevent vision loss, the agency added.

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Fox News Digital reached out to the study researchers and the Alzheimer’s Society for additional comment.

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