Updated 07 December 2017

Shocking: Here's why we have only 35 state cardiologists in SA

There are no cardiologists in public service in five of South Africa’s nine provinces.

South Africa currently has about 175 active, registered cardiologists practising in the country, of which only about 35 are in public service or working in training centres.

This alarming figure was revealed recently by experts at the Cardiovascular Imbizo held in Sandton earlier this month.

“We have a massive shortage of cardiologists, especially in the public sector,” said Professor Andrew Sarkin, head of the University of Pretoria’s department of cardiology, adding that not enough new cardiologists were being trained.

A major epidemic

He said cardiovascular disease – including ischaemic heart disease, strokes, hypertension, heart failure and the complications of diabetes – was a major epidemic facing the country.

“If we don’t deal with this crisis and see this as an emergency, we are going to have a massive problem on our hands like we did in infectious epidemics,” he said.

In order for the country to overcome the cardiologist shortage, Sarkin said South Africa needs a well targeted, comprehensive plan to boost the number of trainees that will eventually provide for the country.

“We need to find a strategy to maintain our trainees within the public sector,” he said, adding that if this was not done quickly, the country could slide back to the crisis levels experience at the start of the HIV epidemic.

Long training

Prof Richard Nethononda, Wits University’s head of cardiology, said there were no cardiologists in public service in five of South Africa’s nine provinces.

“All those provinces send their patients to Gauteng, KZN and the Western Cape,” he said.

According to Nethononda, one of the possible causes was the many years of training needed to become a qualified cardiologist.

“To qualify as a cardiologist, you need 16 years of studying, which is really too long,” he said, suggesting that this alone was discouraging medical doctors from undertaking the rigorous and extensive training.

Not enough posts

He added that once qualified, cardiologists found that there were simply not enough training posts in the public sector. 

“The training environment in the public sector is getting less and less attractive,” he said, adding that this was compounded by a significant lack of infrastructure and equipment.

“Younger people these days are concerned about the public service facilities which are outdated, coupled with a lack of transparent management. They are not prepared to struggle when they know that there is so much wastage,” said Nethononda.

According to Nethononda, poor patients who could not afford the costs of heart surgery were not being properly accommodated for within the public health system.

“Why is it easy for the government to bailout SAA with billions every year, but it is difficult to support public hospitals?” he asked.

The Imbizo focused on the challenges of cardiovascular diseases in the country, and the need for targets based on international best-practice.

“We need government to put into place proper mechanisms to achieve the correct cardiovascular physician to population ratio to address the needs of our people,” said Professor Liesl Zuhlke, President of the South African Heart Association and convenor of the meeting. – Health-e News.