A critical shortage of cardiologists affects care nationwide

Today’s edition: Reproductive health groups are bracing for an influx of patients from Iowa as the state’s new abortion ban goes into effect, and federal regulators are warning patients about medication risks associated with compounded versions of popular drugs such as Ozempic and Wegobee. But first …

America needs more cardiologists

America has a supply and demand problem when it comes to heart disease: the disease is the nation’s leading cause of death, yet nearly half of counties don’t have a single cardiologist.

this is, Brigham and Women’s Hospital Boston found They looked into everything. 3,143 United States counties; 46 percent They don’t have cardiologists. And what’s worse, the counties most likely to not have cardiologists are also the ones that need them the most. These counties are primarily rural and have higher rates of telltale signs of heart disease, such as smoking, diabetes, obesity, and high blood pressure.

The cardiologist problem forms part of a larger local health care crisis that has been going on for decades. Robert A. Harrington,Dean Weill Cornell Medicinedescribes the rural-urban health care disparity this way: “Your zip code says more about your health status than your genetic code,” he says, “and that’s certainly true in rural America.”

Since January 2005, 192 local hospitals Hospitals across the country have been closing or being converted to non-inpatient facilities, and the gap in urban and rural death rates has nearly tripled in the two decades leading up to 2019.

In cardiology, the impact has been severe, straining both patients and doctors. Tate, who has congestive heart failure, said even Sacramento doesn’t have enough cardiologists to meet the demand. It can take months to get an appointment with a local doctor.

“It’s more than just a pain,” she said of driving three hours to see her doctor at Stanford. “At times, I had other illnesses and injuries that made it difficult for me to get in the car and drive.”

Steven Segal He is one of two full-time cardiologists in Titus County, Texas, serving a four-county area. 3,000 Square miles, which is an area with high rates of heart disease.

“It’s rare that we work less than 12 hours a day,” Sigal said.It is not uncommon to work 16-18 hours a day..”

Uthman SalahuddinCardiologist Ochsner Rush Health Residents of Meridian, Mississippi, believe that the surrounding Lauderdale County 11 There are other cardiologists out there, but not in neighboring counties.

“We don’t have cardiothoracic surgery or electrophysiology, which are cardiology specialties,” Saladin said, “so we have to do a triage evaluation and then send patients to places like Hattiesburg, which is an hour and a half away, or New Orleans, which is about three hours away.”

Attracting cardiologists to rural areas is not easySalahuddin, who attended medical school in his native Pakistan, had a special Training Visa More programs like the one in the US that require doctors to work in underserved areas for three years could help alleviate the cardiologist shortage.

Using telemedicine to connect patients with far-flung doctors could also help, but experts suggest health officials will likely need to find other innovative programs. Read my full story here.

Iowa’s abortion ban goes into effect, as residents flee state in search of care

Planned Parenthood Abortions will continue to be available in Iowa, but only in very limited circumstances permitted by the state’s new abortion ban, which took effect this morning, the Post reports. Annie Gowen I will report.

Important context: The law limits the procedure to after fetal cardiac activity can be detected, usually after the sixth week of pregnancy, with exceptions in cases of rape, incest, “non-viable” fetal abnormalities or if the mother’s life is at risk.

Previously, Iowa allowed abortions up to 22 weeks into a pregnancy. is more than 4,000 steps This number was at least 10,000 in the state last year. 97 percent Under the new ban, Ruth Richardsonpresident and CEO of Planned Parenthood North Central States.

Reproductive health groups in neighboring states where fertility treatments are legal are already seeing an influx of patients from Iowa. Chicago Abortion Fund Received more than 60 support requests from Iowa residents during the first three weeks of July 165 percent This is an increase compared to the previous month.

Meanwhile, the situation across the country is as follows:

• Texas: Attorney General Ken Paxton Republicans are suing the Biden administration over policies that allow minors to access contraception without parental consent, arguing the rules violate state law, fellow lawmakers said. Dan Rosenzweig-Ziff I will report.
• Nebraska: State Supreme Court Upheld the law A bill banning abortions after 12 weeks of pregnancy and restricting gender-affirming care for minors, the Supreme Court ruled, did not violate a state constitutional amendment that requires bills to address a single subject by combining those issues. Nebraska Examiners Aaron Sanderford I will report.
• Arizona: judgement Rejected the effort He criticized Republican lawmakers for describing fetuses as “unborn human beings” in a summary of a ballot measure on abortion rights, finding the language “filled with emotion and partisan overtones.” Sejal Govinda Rao Report Associated Press.

FDA warns of mis-dosing of combination weight-loss drug

of Food and Drug Administration Warns patients and doctors Regarding administration errors related to combination drugs of semaglutide Novo NordiskThe blockbuster weight loss and diabetes drug.

Federal regulators said in a warning Friday that they have received reports of adverse events possibly related to overdoses, some of which have required medical treatment or hospitalization. Officials cited cases of patients not knowing how to measure doses into a syringe and health care workers misusing metric conversions and calculating incorrect doses, resulting in patients dying. Five to ten times higher than expected.

Why is this important: Generic versions of Ozempic and Vigovi are Continuing shortages Of brand-name drugs. Although the FDA exercises some oversight over compounding pharmacies, compounding pharmacy drugs are not subject to premarket review by the agency for safety, effectiveness, or quality.

• Department of Justice New court documents allege China-based owner of TikTok The Post built a search tool that allowed employees to gather U.S. users’ opinions on divisive issues such as abortion, gun control and religion. Victoria Bisset and Drew Harwell report.
• Pharmaceutical manufacturer Indivior An $86 million settlement was reached. 16 states The company offered financial support amid allegations that it has contributed to the nation’s opioid epidemic, and the funds will be used to support addiction treatment, recovery and prevention programs.
• California’s Medicaid program paid out about $20 million in just one month. To obtain health care services on behalf of recipients who were simultaneously enrolled in safety net programs in other states. HHS Inspector General Audit.

📅 Welcome back! The Senate is in session, but the House is on recess until September. Here’s what we’re keeping an eye on.

Plan of this week: The Senate is set to vote on two bills that would strengthen privacy and safety protections for children online. If passed, the bills would be the most significant tech regulations passed by Congress in decades, The Washington Post reports. Cristiano Lima-Strong.

on wednesday: of Senate Committee on Health, Education, Labor and Pensions Mark it up Reauthorization Legislation Older Americans Act and two other bills. Senate Judiciary Subcommittee investigate Giving birth in prison.

On Thursday: of Senate Appropriations Committee Mark it up Legislation to raise funds Ministry of Health and Human Services Other Agencies, FY2025; Senate HELP Committee Consider Mark EskenaziAppointment Occupational Safety and Health Review Committee.

on friday: Independent Advisor to the FDA I will review Zebra TherapeuticsA new drug, arimoclomol, has been developed to treat Niemann-Pick type C, a rare genetic disorder.

Kamala Harris’ views on health care were shaped by her mother, cancer researcher Shyamala Gopalan (Rohan Rajeev | Stat)

The Unlikely Alliance That’s Bringing Big Tech to Its Knees (Ruth Rieder | Politico)

Alzheimer’s blood test is 90% accurate, better than other tests (Andrew John | The Washington Post)

Acne medication caused rare chain reaction that killed them (Katherine Ellison | The Washington Post)

Thanks for reading. Not a subscriber yet? Sign up here.