THE PRACTICE OF PEDIATRIC CARDIOLOGY IN AN EVOLVING HEALTH-CARE SYSTEM

Changes in our health care system proceed regardless of federal legislative activity. A significant component of reform affects specialty; high technology in-hospital care such as pediatric cardiology by attempting to focus on changing the emphasis toward a primary, outpatient model. This paper reviews some of the evolutionary events and processes affecting our health care delivery system. These events include: expanding high technology medicine; forces influencing regionalization of specialty care such as expansion of academic health centers; reimbursement sources and medical liability; and increasing control by major purchases of health care. Finally we review how the pediatric cardiologist and the practice of this specialty may evolve as a result of these events.