[The imbalance between supply and demand for cardiologists in Spain].

The lack of cardiologists (and of other specialists) is a serious problem that occurs, among other things, because of the poor vision of politicians. Thus, at this point, it would be dangerous to leave them to deal with this issue alone. For this reason, we welcome the fact that the Spanish Society of Cardiology offers this article,1 with respect to which I would like to make a few comments. 1. Concerning the “shortcut” for training clinical cardiologists. In the United States (35th Bethesda Conference),2 cardiologists of this type are mostly found in private medicine. In Europe, with its public health systems, this shortcut is not an option, at least as far as we know. The clinical cardiologist is a key figure and should be highly trained and experienced (the “long way around”). In fact, the lack of good clinical cardiologists has also been lamented in the United States.3 The existence of “first class” and “second class” cardiologists in the public health system would create professional envy, as has already occurred with the “MESTOS” (medical specialists without official degrees). The Spanish Society of Cardiology should never downgrade cardiologic training, quite the contrary. We should not respond to the lack of cardiologists by creating a group of aides to work in the ambulatory setting. 2. Concerning the importation of cardiologists. This would be possible if the salaries were raised; otherwise, we would import cardiologists from poorer countries with questionable training. The relaxation of the minimum training criteria required of foreign cardiologists is always a bad move. 3. Concerning the modification of the structure of the cardiology services and the integration of physicians who are not cardiologists. This, I feel, is the road to follow. The plan should: a) increase the number of cardiology interns; b) redistribute the cardiologists we have; and c) incorporate general practitioners involved in the treatment of cardiovascular diseases.