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.

“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.”

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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.

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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.

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.

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.

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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.

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.

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“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.”

“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).

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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.

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. 

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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.”

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.

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

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.” 

“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.

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.”

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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