A Heart Rhythm Society Electrophysiology Workforce Study: Current survey analysis of physician workforce trends


      Recent economic trends influenced by healthcare reform, an aging population, changes in physician reimbursement, and increasing competition will have a significant impact on the electrophysiology workforce. Therefore, there is an important need to obtain information about the EP workforce to assess training of arrhythmic healthcare providers in order the meet the requisite societal need. This report summarizes the data collected by the HRS Workforce Study Task Force in relation to physician workforce issues.


      The HRS Workforce Study Task Force was charged with conducting a comprehensive study to assess changes in the field of electrophysiology since the last workforce study conducted in 2001 and to identify the population and distribution of professionals who treat patients with heart rhythm disorders.


      A series of comprehensive questionnaires were designed by the HRS Workforce Study Task Force to conduct online surveys with physicians, basic science researchers, and allied professionals. Data collected in the physician survey included: personal demographics and professional profile characteristics such as primary work setting and areas of affiliation; workload characteristics such as hours worked, time spent by activity, workload relative to capacity, competition for patients, volume by specific procedure, sources of referrals, income levels, personal mobility, and anticipated future changes in the respondent's practice. Survey responses were collated and analyzed by the Workforce Study Task Force.


      Work capacity is expected to increase to offset some of the economic drivers; however, recruitment of new EPs could be challenging and uncertain. Specifically, geographic mobility (>50 miles) appears to be minimal at present overall and unlikely to significantly change for the majority of physicians once they have established themselves in a given community following the completion of their training. Practice time is predominantly spent performing device implantations, device follow-ups and ablations. These activities are being tasked upon younger physicians, thereby suggesting a need for trained allied professionals to assume a greater role in device management. The perception of competition varied by respondent age and geographic location but, in general, was felt to be at least moderate by most respondents. Furthermore, there are concerns that increasing competition may dilute operator experience and potentially lower high quality outcomes if increasing competition leads to lower procedural volumes.


      Based on findings from this study, the task force identified specific workforce (supply) trends and the key drivers of current and future challenges. Although specific areas will require further analysis, overall, the current EP workforce is stable, with the exception of geographic dispersion. However, the workforce must adapt to the key economic drivers (demand) and address future recruitment challenges.



      EP (electrophysiology/electrophysiologist), HRS (Heart Rhythm Society), IBHRE (International Board of Heart Rhythm Examiners (formerly NASPExAM)), ICD (implantable cardioverter defibrillator), non-EP (affiliations other than clinical electrophysiology)
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      1. Heart Rhythm Society. Strategic Planning Initiative (SPI) research, 2007–2008 survey of 462 U.S.-based EPs and affiliated heart rhythm physician specialists.

      2. Heart Rhythm Society. Physician Workforce Study 2001–2002.

      3. Heart Rhythm Society. iMIS10 Management System. Advanced Solutions International, Inc., 2009–2010.

        • Naccarelli G.V.
        • Conti J.B.
        • DiMarco J.P.
        • Tracy C.M.
        Task force 6: training in specialized electrophysiology, cardiac pacing and arrhythmia management.
        J Am Coll Cardiol. 2006; 47: 904-910
        • U.S. Census Bureau, Census 2000 population by state
        (Accessed on February 16, 2010)
        • Baruch Y.
        Response rate in academic settings—A comparative analysis.
        Hum Relations. 1999; 52: 421-438
        • Lindsay B.D.
        • Estes N.A.M.
        • Maloney J.D.
        • Reynolds D.W.
        Heart Rhythm Society Policy Statement Update: Recommendations on the Role of Industry Employed Allied Professionals (IEAPs).
        Heart Rhythm. 2008; 5: e8-e10
        • Curtis J.P.
        • Luebbert J.J.
        • Wang Y.
        • Rathore S.S.
        • Chen J.
        • Heidenreich P.A.
        • Hammill S.C.
        • Lampert R.I.
        • Krumholz H.M.
        Association of physician certification and outcomes among patients receiving an implantable cardioverter-defibrillator.
        JAMA. 2009; 301: 1661-1670
        • Al-Khatib S.M.
        • Lucas F.L.
        • Jollis J.G.
        • Malenka D.J.
        • Wennberg D.E.
        The relation between patients' outcomes and the volume of cardioverter-defibrillator implantation procedures performed by physicians treating Medicare beneficiaries.
        J Am Coll Cardiol. 2005; 46: 1536-1540
        • Chugh S.S.
        • Donahue J.K.
        • Kaufman E.S.
        • Link M.S.
        • Markowitz S.M.
        • Narayan S.M.
        • Quan K.J.
        • Tomaselli G.F.
        • Verdino R.
        The future of fellowship training in clinical cardiac electrophysiology: Program directors' perspective 2008.
        Heart Rhythm. 2009; 6: 1606-1612


        • Deering T.F.
        • Clair W.K.
        • Delaughter M.C.
        • Fisher W.G.
        • Garlitski A.C.
        • Wilkoff B.L.
        • Gillis A.M.
        A Heart Rhythm Society Electrophysiology Workforce Study: Current survey analysis of physician workforce trends.
        Heart Rhythm Society. 2010;