Cardiac surgery in the 21st century

Cardiac surgery has developed over the past four decades in the United States as an important component of the entire health rare industry. When analyzed as an industry, it is apparent that cardiac surgery is transitioning from its emerging or rapid growth phase to that of a mature industry. This transition, when combined with the global changes occurring in all of health care, has caused payers to reassess the value of cardiac surgical services and they have been targeted as overvalued and consuming a disproportionate share of health care resources. Several options are available to cardiac surgeons as to how they may potentially respond to the changes that are occurring in the external environment and reshaping the practice of the specialty. The active adaptation strategy appears to be the preferred choice but will require a substantial shift in the way cardiac surgery is practiced and reimbursed in the future. (C) 1997 by The Society of Thoracic Surgeons.