• Daniel M Blumenthal, Bassem Mikhael, Patrick R Lawler, Robert W Yeh, Joshua P Metlay, and David M Dudzinski.
• Division of Cardiology, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA.
• Crit. Care Med. 2017 Dec 1; 45 (12): e1292-e1296.

ObjectivesEvaluate the characteristics of U.S. physicians who are board certified in cardiology and critical care medicine ("dual-boarded cardiologists").DesignRetrospective cross-sectional study using a comprehensive database of licensed U.S. physicians linked to Medicare claims.SettingThe United States.SubjectsDual-boarded cardiologists.Measurements And Main ResultsWe used a comprehensive physician database to identify all physicians who were board certified in cardiology and critical care medicine before July 2015. We assessed physicians' characteristics and compared dual-boarded cardiologists with and without active board certification in critical care medicine and estimated the maximum proportion of 2014 Medicare Cardiac ICU admissions treated by dual-boarded cardiologists. Among 473 dual-boarded cardiologists, 16 (3.4%) were women; 468 (99%) and 85 (18%) maintained active board certification in cardiology and critical care medicine, respectively. Overall, 98 dual-boarded cardiologists (21%) submitted 1,215 total claims for critical care services in 2014. Compared to dual-boarded cardiologists without active board certification in critical care medicine, those with active certification had more publications (median publications: 6.5 vs 3.0; p = 0.002), were more likely to be professors (22.3% vs 9.5%; p = 0.003), and were more likely to bill Medicare for critical care services (29% vs 17.8%; p = 0.002). We estimated that no more than 0.47% of all 2014 Medicare Cardiac ICU admissions were treated by a dual-boarded cardiologist.ConclusionsDual-boarded cardiologists appear to deliver a small proportion of all Cardiac ICU services received by Medicare beneficiaries. Optimizing the modern Cardiac ICU workforce will require greater efforts to promote and support the training of dual-boarded cardiologists.

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