Survey results from the ESC Council for Cardiology Practice

Country participation

As seen in Table 1 the country with the highest participation rate was Italy (114 participants). Russia, Greece, Spain and Ukraine were also among the top 5 countries.

It is of interest to note that many eastern European countries without representation in our Council* were among the most active in the survey:  Russia, Ukraine, Romania, Poland and Bulgaria.

The mean age of responders was 48 and 28 % of them were female.  The percentage of female cardiologists varies much between countries with more female cardiologists in practice in Eastern Europe (see Table 1).

* We would like to remind our readers that is easy for a country to become a member of CCP. Please contact councils@escardio.org for information.

Percentage of working time spent in practice

The practicing cardiologists represent  a group with wide experience:  61% of participants had more than 10 years of practice after having received their cardiology certification. 

The proportion of work done in the cardiology practice and in hospitals varies:  38% reported that they worked at least 90% of their time in office practice whereas 31 % spent less than 50% of their working time in their practice.

This also differs between countries (as shown in Table & Graph 2) depending on differences in the organization of specialized health care. In some countries most cardiologists work part time in their office and part time in non-academic or in university hospitals whereas in many countries this combination is more uncommon or regulatorily forbidden.

Patients average age and main disease category

The participating cardiologists were requested to characterize the patients who consulted on the day of the survey by age and by main disease category.

• The mean age of patients seen that day was 57 years
• 53% were male
• 28 % were aged 70 and above.

As shown in Table & Graph 3 the five most frequent symptom/disease groups were evaluation of chest pain, hypertension,  known coronary artery disease and atrial fibrillation.

Diagnostic procedures

A total of 534 cardiologists also gave information about the diagnostic procedures performed on the survey day.

As shown in Table & Graph 4 the vast majority performs standard out-patients procedures like ECG, Exercise ECG, Transthoracic Echo, Holter ECG and ambulatory BP monitoring. 

More specialized procedures like Stress ECHO, Cardiopulmonary Exercise testing, Tilt Table Testing and Body Box testing were done by a significant proportion.

This shows that the practicing cardiologists in many countries perform advanced procedures often thought of as belonging to hospital based cardiology.

New echocardiographic techniques

Newer echocardiographic techniques are also being adopted by practicing cardiologists:

• Use of TDI to obtain E/e’ was reported by 2/3 of the participants
• 2-D speckle strain was used by one in four participants
• 3-D echo was used by one in five participants

ESC Congresses

Continued medical education is of prime importance and we also asked whether they had attended the last ESC congresses. Of the 867 cardiologists 35% had attended either ESC Congress 2011 or ESC Congress 2012.

The cost of congress, travel and accommodation was:

• sponsored totally by industry for 50% of the participants
• sponsored partly by industry for 12%
• paid on their own budget for 34%
• funded by their employer/hospital for 4%. 

Conclusion

This survey has brought important information regarding European cardiologists working in out-of hospital offices.  In a future “borderless” Europe also regarding cardiology practice, such information is crucial to describe similarities and differences between the ESC countries regarding cardiology office practice.

The ESC Council of Cardiology Practice will continue to develop targeted surveys to describe the working conditions and the work done by practicing cardiologists. 


Table 1. Number of answers to the survey by country

Table 2. Percentage of working time spent in practice

Table 3. Main symptom/disease groups for patients seen on the day of survey

Table 4. Procedures performed by the participating cardiologists (534 answers)

The Council for Cardiology Practice thanks everyone who participated in this survey