Half of New Zealand's cardiology workforce will be nearing retirement by 2039. Photo: 123rf.com
- Half New Zealand's cardiology workforce nearing retirement by 2039
- NZ needs 38 percent more specialists to match Australia
- Wait times continue to increase
- More "flexibility" needed to attract and retain staff.
More than half the country's heart specialists are over 50, and nearly one in five is older than 60, a new study has found.
The paper published in The New Zealand Medical Journal on Friday is based on a survey sent by the Cardiac Society of Australia and New Zealand last year to all its members working in public hospitals.
Lead author Dr Selwyn Wong said of the 154 Health NZ-employed cardiologists, over half were over 50, and 35 percent were over 55 - including 18 percent who were older than 60.
"So, while it's a blunt tool, the expectation is that some of those older ones might be leaving the profession. And we've seen some examples of that, people leaving the public system and going into private practice towards the end of their careers, or leaving the profession completely."
Dr Wong, who has worked at Middlemore Hospital for 25 years himself, said the workload on cardiologists had got increasingly intense over time, with more referrals, sicker patients - but fewer resources.
"Over the years we've seen more resource constraints, not just in cardiology but right across the hospital.
"More and more is being squeezed out of the workforce, so you're ending up doing more and more work, with less down time."
The survey found 14 percent of cardiology positions were vacant.
Dr Wong said, however, that was just the "funded" positions - not an indication of the true number of specialists needed to deal with increased demand.
Dr Selwyn Wong. Photo: Supplied / Allevia Cardiology Ascot
"We have one cardiologist per 35,000 people, while Canada and Australia have one cardiologist per 25,000 people, and I think in Sydney it's one per 15,000.
"So if we want to match those places, we'd need to go from 154 to 213: an extra 60 cardiologists, or a 38 percent increase on what we have now."
Furthermore, cardiologists were not evenly distributed across the country.
In the five districts with the highest proportion of Māori and Pacific peoples (who had the worst rates of heart disease) the ratios of specialists to population exceed the national average: Tairāwhiti 54,000; Counties Manukau 38,000; Lakes 61,000; Northland 52,000; Hawke's Bay 47,000.
A separate study published in The New Zealand Medical Journal on Friday showed after half a century of heart attacks trending down, progress had stalled - with a widening ethnic disparity for Māori and Pacific people.
Dr Wong said specialist assessment referrals and the wait times for those appointments were rising, along with delays for cardiac ultrasound and cardiac catheterisation.
The shortfalls were exacerbated by demands and employment patterns during and after the Covid-19 pandemic.
"The staffing might be acceptable if everyone is at work, but not everyone is at work because people are allowed leave or they get sick or they're at conferences.
"We've calculated that in our department most of the time there are two people away out of a staff of 16 or 18."
The survey found about 73 percent of cardiologists working in New Zealand were trained in this country.
Dr Wong said, however, other internationally-trained cardiologists and New Zealand trained specialists now working overseas could be encouraged to take up jobs here, if they had access to the kind of resources they were used to.
"Some more flexibility would help, and that would also help retain those older specialists we have in the system now, for whom being on call so often is increasingly burdensome."
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