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.
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In a dramatic turn of events that’s captured the attention of animal lovers worldwide, Punch — the young macaque at a zoo in Japan famous for his inseparable bond with a stuffed orangutan toy — has reached a major milestone in his journey toward social integration.
On Thursday, visitors and staff at the Ichikawa Zoological and Botanical Garden witnessed a breakthrough: Punch was seen cuddling with and hitching a ride on the back of a fellow macaque.
Punch’s story began with hardship. He was abandoned by his mother shortly after his birth in July 2025 — and to ensure his survival, zookeepers stepped in to hand-rear the primate.
On Jan. 19, 2026, the zoo officially began the process of reintegrating Punch into the “monkey mountain” enclosure.
The transition was initially fraught with tension.
Punch’s story began with hardship when he was abandoned by his mother shortly after he was born. To help him, zookeepers gave him a stuffed toy that he began dragging around everywhere he went. (David Mareuil/Anadolu via Getty Images)
As a hand-reared infant, Punch was bullied and ignored by the established group of monkeys.
He was often seen huddled alone with his orange plush companion while the rest of the troop interacted.
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In an official statement released Feb. 27, the Ichikawa Zoological and Botanical Garden detailed the meticulous care behind this process.
Previous viral videos showed Punch bullied by the rest of the troop, running to his plushy toy for comfort. (David Mareuil/Anadolu via Getty Images)
“From an animal welfare perspective, our primary goal is to reintegrate Punch with the troop,” the zoo said.
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The strategy involved nursing Punch within the enclosure, so the troop could recognize him as one of their own, and pairing him with a gentle young female macaque prior to his full release to build his confidence.
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The latest footage, captured by X user @tate_gf, suggested the zoo’s patience is paying off.
The video shows Punch seeking physical contact not from his toy, but from another monkey — eventually climbing onto its back for a vital social behavior for young macaques: the “piggyback ride.”
The zoo’s strategy appears to be paying off: Punch, shown at far left, was recently seen riding on the back of a fellow macaque. (David Mareuil/Anadolu via Getty Images)
While Punch still carries his stuffed toy for comfort during moments of perceived danger, the zoo remains optimistic about his progress.
The organization cited the successful 2009 case of Otome, another hand-reared macaque who eventually outgrew her stuffed toy, successfully integrated — and went on to raise four offspring of her own.
The zoo has had crowds coming to see Punch, with hundreds of people lining up to get inside to see the young star, according to reports.
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“I’m hoping Punch has a good life like everybody else does, and think he’s a cute little guy,” one person commented online.
“Such a precious baby,” another person wrote.
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This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
Artificial intelligence has been touted as a boon to healthcare, but a new study has revealed its potential shortcomings when it comes to giving medical advice.
In January, OpenAI launched ChatGPT Health, the medical-focused version of the popular chatbot tool.
The company introduced the tool as “a dedicated experience that securely brings your health information and ChatGPT’s intelligence together, to help you feel more informed, prepared and confident navigating your health.”
But researchers at the Icahn School of Medicine at Mount Sinai have found that the tool failed to recommend emergency care for a “significant number” of serious medical cases.
The study, published in the journal Nature Medicine on Feb. 23, aimed to explore how ChatGPT Health — which is reported to have about 40 million users daily — handles situations where people are asking whether to seek emergency care.
Artificial intelligence has been touted as a boon to healthcare, but a new study has revealed its potential shortcomings when it comes to giving medical advice. (iStock)
“Right now, no independent body evaluates these products before they reach the public,” lead author Ashwin Ramaswamy, M.D., instructor of urology at the Icahn School of Medicine at Mount Sinai in New York City, told Fox News Digital.
“We wouldn’t accept that for a medication or a medical device, and we shouldn’t accept it for a product that tens of millions of people are using to make health decisions.”
Emergency scenarios
The team created 60 clinical scenarios across 21 medical specialties, ranging from minor conditions to true medical emergencies.
Three independent physicians then assigned an appropriate level of urgency for each case, based on published clinical practice guidelines in 56 medical societies.
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The researchers conducted 960 interactions with ChatGPT Health to see how the tool responded, taking into account gender, race, barriers to care and “social dynamics.”
While “clear-cut emergencies” — such as stroke or severe allergy — were generally handled well, the researchers found that the tool “under-triaged” many urgent medical issues.
The team created 60 clinical scenarios across 21 medical specialties, ranging from minor conditions to true medical emergencies. (iStock)
For example, in one asthma scenario, the system acknowledged that the patient was showing early signs of respiratory failure — but still recommended waiting instead of seeking emergency care.
“ChatGPT Health performs well in medium-severity cases, but fails at both ends of the spectrum — the cases where getting it right matters most,” Ramaswamy told Fox News Digital. “It under-triaged over half of genuine emergencies and over-triaged roughly two-thirds of mild cases that clinical guidelines say should be managed at home.”
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Under-triage can be life-threatening, the doctor noted, while over-triage can overwhelm emergency departments and delay care for those in real need.
Researchers also identified inconsistencies in suicide risk alerts. In some cases, it directed users to the 988 Suicide and Crisis Lifeline in lower-risk scenarios, and in others, it failed to offer that recommendation even when a person discussed suicidal ideations.
“ChatGPT Health performs well in medium-severity cases, but fails at both ends of the spectrum.”
“The suicide guardrail failure was the most alarming,” study co-author Girish N. Nadkarni, M.D., chief AI officer of the Mount Sinai Health System, told Fox News Digital.
ChatGPT Health is designed to show a crisis intervention banner when someone describes thoughts of self-harm, the researcher noted.
OpenAI launched ChatGPT Health, the medical-focused version of the popular chatbot tool, in January 2026. (Gabby Jones/Bloomberg via Getty Images)
“We tested it with a 27-year-old patient who said he’d been thinking about taking a lot of pills,” Nadkarni said. “When he described his symptoms alone, the banner appeared 100% of the time. Then we added normal lab results — same patient, same words, same severity — and the banner vanished.”
“A safety feature that works perfectly in one context and completely fails in a nearly identical context … is a fundamental safety problem.”
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The researchers were also surprised by the social influence aspect.
“When a family member in the scenario said ‘it’s nothing serious’ — which happens all the time in real life — the system became nearly 12 times more likely to downplay the patient’s symptoms,” Nadkarni said. “Everyone has a spouse or parent who tells them they’re overreacting. The AI shouldn’t be agreeing with them during a potential emergency.”
Fox News Digital reached out to Open AI, creator of ChatGPT, requesting comment.
Physicians react
Dr. Marc Siegel, Fox News senior medical analyst, called the new study “important.”
“It underlines the principle that while large language models can triage clear-cut emergencies, they have much more trouble with nuanced situations,” Siegel, who was not involved in the study, told Fox News Digital.
ChatGPT and other LLMs can be helpful tools, a doctor said, but they “should not be used to give medical direction.” (iStock)
“This is where doctors and clinical judgment come in — knowing the nuances of a patient’s history and how they report symptoms and their approach to health.”
ChatGPT and other LLMs can be helpful tools, Siegel said, but they “should not be used to give medical direction.”
“Machine learning and continued input of data can help, but will never compensate for the essential problem – human judgment is needed to decide whether something is a true emergency or not.”
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Dr. Harvey Castro, an emergency physician and AI expert in Texas, echoed the importance of the study, calling it “exactly the kind of independent safety evaluation we need.”
“Innovation moves fast. Oversight has to move just as fast,” Castro, who also did not work on the study, told Fox News Digital. “In healthcare, the most dangerous mistakes happen at the extremes, when something looks mild but is actually catastrophic. That’s where clinical judgment matters most, and where AI must be stress-tested.”
Study limitations
The researchers acknowledged some potential limitations in the study design.
“We used physician-written clinical scenarios rather than real patient conversations, and we tested at a single point in time — these systems update frequently, so performance may change,” Ramaswamy told Fox News Digital.
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Additionally, most of the missed emergencies happened in situations where the danger depended on how the condition was changing over time. It’s not clear whether the same problem would happen with acute medical emergencies.
Because the system had to choose just one fixed urgency category, the test may not reflect the more nuanced advice it might give in a back-and-forth conversation, the researchers noted.
ChatGPT Health is designed to show a crisis intervention banner when someone describes thoughts of self-harm. (iStock)
Also, the study wasn’t large enough to confidently detect small differences in how recommendations might vary by race or gender.
“We need continuous auditing, not one-time studies,” Castro noted. “These systems update frequently, so evaluation must be ongoing.”
‘Don’t wait’
The researchers emphasized the importance of seeking immediate care for serious issues.
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“If something feels seriously wrong — chest pain, difficulty breathing, a severe allergic reaction, thoughts of self-harm — go to the emergency department or call 988,” Ramaswamy advised. “Don’t wait for an AI to tell you it’s OK.”
The researchers noted that they support the use of AI to improve healthcare access, and that they didn’t conduct the study to “tear down the technology.”
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“These tools can be genuinely useful for the right things — understanding a diagnosis you’ve already received, looking up what your medications do and their side effects, or getting answers to questions that didn’t get fully addressed in a short doctor’s visit,” Ramaswamy said.
“That’s a very different use case from deciding whether you need emergency care. Treat them as a complement to your doctor, not a replacement.”
“This study doesn’t mean we abandon AI in healthcare.”
Castro agreed that the benefits of AI health tools should be weighed against the risks.
“AI health tools can increase access, reduce unnecessary visits and empower patients with information,” he said. “They are not inherently unsafe, but they are not yet substitutes for clinical judgment.”
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“This study doesn’t mean we abandon AI in healthcare,” he went on. “It means we mature it. Independent testing and stronger guardrails will determine whether AI becomes a safety net or a liability.”
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