A serious shortage of cardiologists is affecting healthcare across the country

Today’s Edition: Reproductive health groups are bracing for a surge of patients from Iowa as the state’s new abortion ban goes into effect. Federal regulators are warning patients about dosage risks associated with compounded versions of popular medications such as Ozempic and Wegovy. But first …

The United States needs more cardiologists

America has a supply-and-demand problem when it comes to heart disease. The disease is the nation’s leading killer, yet nearly half of all counties have no cardiologists.

That is what a research team of Brigham and Women’s Hospital In Boston they discovered when they investigated everything 3,143 US counties; more than 46 percent had no cardiologist. Worse, the counties most likely to have no cardiologist are the very counties most likely to need one. These are largely rural areas with high rates of smoking, diabetes, obesity, and high blood pressure — the telltale signs of heart disease.

The cardiologist problem is part of a larger, decades-long crisis in rural health care. Robert A. Harringtondean of Weill Cornell Medicinedescribes the disparity between health care in rural and urban areas this way: “Your zip code tells you more about your health outcomes than your genetic code,” he said. “And that’s certainly the case in rural America.”

Since January 2005, 192 rural hospitals nationwide have been closed or converted to non-clinical care facilities. And in the 20-year period through 2019, the difference in mortality rates between urban and rural areas has nearly tripled.

In cardiology, the effects are acute, burdening both patients and doctors. Tate, who has congestive heart failure, said there aren’t enough cardiologists even in Sacramento to meet the need. It can take months to get an appointment with a local doctor.

“It’s more than an ordeal,” she said of the three-hour drive to her doctor in Stanford. “There have been times when I’ve had other illnesses and injuries that have made it difficult for me to get in my car and drive.”

Stephen Sigal is one of two full-time cardiologists in Titus County, Texas, which serves a four-county area of ​​approximately 3,000 square miles. It is an area plagued by high levels of heart disease.

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

Usman Salahuddina cardiologist for Ochsner Rush Health in Meridian, Miss., said surrounding Lauderdale County 11 other cardiologists. But there are none in the neighboring provinces.

“We don’t have cardiothoracic surgery or electrophysiology, which are specialties within cardiology,” Salahuddin said. “So we do the initial triage assessment and then we have to refer them in turn,” as far as Hattiesburg, an hour and a half away, or even New Orleans, about a three-hour drive.

Attracting cardiologists to rural areas has not been easy. Salahuddin, who went to medical school in his native Pakistan, said he was granted a special visa to train in the United States, which required him to work as a doctor in an underserved area for three years. More such programs could help address the shortage of cardiologists.

Using telemedicine to connect patients with their distant doctors could also help. But experts suggest health officials will likely need to find other innovative programs. Read my whole story here.

Iowa abortion ban goes into effect as residents flee state for care

Planned Parenthood will continue to perform abortions in Iowa, but only under the very limited circumstances allowed by the state’s new abortion ban, which went into effect this morning, The Post reported. Annie Gowen defeated.

Important context: The law limits the procedure to after fetal heart activity can be detected, usually about six weeks into the pregnancy. There are exceptions for cases of rape, incest, a fetal abnormality that is “incompatible with life,” or if the mother’s life is in danger.

In Iowa, abortion was previously legal up to 22 weeks of pregnancy. More than 4,000 interventions were carried out in the state last year, a number that is expected to drop by at least 50%. 97 percent under the new ban, according to Ruth Richardsonpresident and CEO of Planned Parenthood North Central States.

Reproductive care groups in neighboring states where the procedure remains legal are already seeing an influx of patients from Iowa. Chicago Abortion Fund more than received 60 support requests of Iowa residents during the first three weeks of July, a 165 percent increase compared to previous months.

Meanwhile, on the other side of the country:

• In Texas: Attorney General Ken Paxton (R) is suing the Biden administration over a policy that allows teens to use contraception without their guardians’ permission, saying the rule violates state law, our colleague says Dan Rosenzweig-Ziff defeated.
• In Nebraska: The state Supreme Court has upheld a law banning abortion after 12 weeks of pregnancy and limiting gender-affirming care for minors, ruling that combining these issues does not violate an amendment to the state constitution that requires bills to address a single subject, Nebraska ExaminerS Aaron Sanderford defeated.
• In Arizona: A judge has rejected an attempt by Republican lawmakers to use the term “unborn human” to describe a fetus in the summary of a ballot measure on abortion rights, saying the wording is “laden with emotion and partisan meaning.” Sejal Govindarao reports for the Associated Press.

FDA warns of dosing errors in compounded weight loss drugs

The Food and Drug Administration warns patients and doctors about dosing errors associated with compounded versions of semaglutide, the active ingredient in New Nordisk‘s best-seller in the field of weight loss and diabetes medicines.

In an alert Friday, the federal regulator said it had received reports of adverse events, some requiring medical attention or hospitalization, that may have been related to overdose. The agency cited cases of patients not knowing how to measure doses with a syringe, and health care providers calculating incorrect doses by confusing metric conversions, resulting in patients who five to ten times more than intended.

Why it matters: Generic versions of Ozempic and Wegovy have become extremely popular due to the ongoing shortages of brand-name drugs. Although the FDA oversees compounding pharmacies, their drugs do not undergo the agency’s premarket review for safety, effectiveness, or quality.

• The Ministry of Justice alleged in new court documents which the China-based owner of TikTok developed a search engine that allowed its employees to gather information about American users’ positions on divisive issues such as abortion, gun control and religion, The Post reported Victoria Bisset And Signed Harwell report.
• Pharmaceutical manufacturer Indivior reached an $86 million settlement with 16 states over the company’s alleged role in fueling the nation’s opioid epidemic. The funds will be used to support addiction treatment, recovery and prevention programs.
• In just one month, California’s Medicaid program paid out nearly $20 million for health care services on behalf of beneficiaries who were simultaneously enrolled in the safety net program in another state, according to an audit by the HHS inspector general.

📅 Welcome back! The Senate is in session, while the House is away until September. Here’s what we’re watching.

This week on the program: The Senate is expected to vote on a pair of bills that would improve children’s online privacy and safety. If the legislation passes, it would be the most significant technology regulation to pass either chamber of Congress in decades, The Post’s Cristiano Lima-Strong.

On Wednesday: The Senate Committee on Health, Education, Labor and Pensions will draft legislation to reauthorize the Older Americans Act and two other bills; Senate Judiciary Subcommittee will investigate birth behind bars.

On Thursday: The Senate Budget Committee will introduce legislation to Ministry of Health and Welfare and other agencies for fiscal year 2025; the Senate HELP Committee will consider this Mark Eskenazi‘s nomination for the Commission for the Assessment of Safety and Health at Work.

On Friday: Independent advisors to the FDA will review the results Zevra Therapeutics‘ new drug, arimoclomol, for the treatment of Niemann-Pick disease type C, a rare genetic disorder.

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

The unlikely alliance that is bringing the tech giants into line (By Ruth Reader | Politico)

Blood test for Alzheimer’s shows 90% accuracy, outperforms other tests (By Andrew Jeong | The Washington Post)

Their acne medications caused a rare chain reaction that proved fatal (by Katherine Ellison | The Washington Post)

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