Beyond its compelling storylines, the emergency room drama The Pitt offers a revealing look at many of the challenges shaping health care today. Burnout, workforce shortages, patient access barriers, workplace violence, and the promise and pitfalls of new technologies are not unique to emergency medicine. They are increasingly familiar realities for cardiovascular professionals navigating a rapidly evolving health care environment.

Perhaps the show's greatest strength is its portrayal of how interconnected these challenges truly are. Clinician well-being, workforce sustainability, patient access and technological innovation cannot be addressed in isolation.

"The Pitt gets a lot right. I especially appreciate that throughout the episodes there is a lot of focus on team dynamics and the interconnectivity within medicine – not just relationships with patients, but within the care team, the hospital as a whole and the local community," says Akshay Khandelwal, MD, FACC, an ACC Trustee and chief of cardiovascular medicine at Allegheny Health Network, the setting for The Pitt. "It underscores the importance of building a health care system that is resilient, equitable and sustainable and the need for coordinated solutions that support both those receiving care and those providing it."

Clinician Mental Health: The Invisible Burden in Cardiology

One of the central themes in The Pitt is the emotional toll of clinical practice. The series portrays workplace violence, grief, moral distress and burnout not as isolated events but as recurring realities woven into everyday patient care.

For cardiovascular clinicians, these challenges may feel especially familiar. "Caring for patients at critical moments such as acute myocardial infarction, advanced heart failure or sudden cardiac arrest, can carry significant but often underappreciated emotional labor, even when outcomes are positive," says Garima Sharma, MBBS, FACC, who has been closely involved in ACC Section and Chapter work, as well as workforce and well-being initiatives.

High patient volumes, demanding call schedules, complex decision-making and administrative burdens can further compound stress. Insurance barriers, resource constraints and situations where recommended therapies do not align with patient goals can heighten moral distress for cardiovascular teams.

The emotional burden also extends beyond clinical complexity. Cardiovascular clinicians often develop long-term relationships with patients and families, creating meaningful connections while increasing the impact of adverse outcomes.

"The patient who dies unexpectedly, the patient or family conversation that stays with you, the complication you replay in your mind long after the procedure – those experiences don't simply disappear," says Laxmi Mehta, MD, MBA, FACC, chair of ACC's Membership Committee and a longtime leader of the College's clinician well-being efforts. "While caring for patients is incredibly rewarding, the cumulative weight of carrying that responsibility over years or decades can be substantial."

Addressing these challenges requires more than encouraging individual resilience. When the demands placed on clinicians consistently outpace available resources, the consequences can affect both caregivers and the broader health care system.

"A strong sense of meaning and purpose in clinical work as well as connection to patients and their families are what sustains many clinicians. But purpose and meaning are not enough, we must acknowledge the psychological cost of repeatedly making high-consequence decisions," says Mehta.

A growing body of research links chronic psychological stress to adverse health consequences for clinicians themselves. At the organizational level, burnout can contribute to lower engagement, reduced team effectiveness, poorer patient experience and higher workforce turnover.

Experts emphasize that meaningful progress requires institutional commitment. "Clinicians have a responsibility to patients, but organizations also have a responsibility to build conditions in which excellent care is sustainable," says CardioSmart Editor Viet Le, DMSc, MPAS, PA-C, FACC. "Burnout is not a failure of character. It is often a signal that demand, resources, autonomy and meaning have moved out of balance."

Sharma advocates for a systems-based approach embedded within organizational culture, including efficient work environments, flexible scheduling, transparent leadership, routine measurement of burnout and stigma-free access to mental health resources.

Mehta also emphasizes the responsibility of leaders to model healthy behaviors and support training environments that prioritize well-being. "Clinician well-being is not a nice-to-have luxury, but a necessary component of every health system and training program," she says. "Creating a culture where clinicians care for themselves and one another is essential not only for workforce sustainability but also for delivering safe, effective, high-quality patient care."

AI and Digital Health: Promise vs. Friction

Another recurring theme in The Pitt is the growing role of technology in clinical decision-making. The show highlights both the promise of digital tools and the frustration that arises when technology fails to integrate smoothly into care delivery or suddenly becomes unavailable.

Cardiovascular medicine sits at the forefront of this transformation. AI-powered documentation tools, advanced imaging platforms, predictive analytics and remote monitoring technologies are increasingly finding their way into clinical practice. When implemented effectively, these tools can help reduce administrative burden, identify patients at higher risk for complications, and extend care beyond the walls of the clinic or hospital.

Yet, as The Pitt illustrates, technology is rarely a simple solution.

Clinicians frequently navigate tension between algorithmic recommendations and clinical judgment. AI tools can uncover patterns that might otherwise be missed, but their performance depends heavily on the data used to develop them. Biases, incomplete information and inaccurate outputs remain important concerns.

At the same time, digital innovation can create new challenges. Remote monitoring programs and connected devices generate large volumes of data that must be reviewed, interpreted and acted upon. Poorly designed workflows can transform tools intended to save time into additional sources of burden.

Equity also remains a critical consideration. Not all patients have reliable internet access, smartphones, wearable devices or the digital literacy needed to engage with emerging technologies. Without careful implementation, new tools risk widening existing disparities in care.

The show also serves as a reminder that health care systems remain vulnerable to technological disruptions, whether from cyberattacks, network failures or power outages. Clinicians must be prepared to continue delivering care when technology is unavailable.

The future of cardiovascular medicine will be shaped not by the adoption of AI alone, but by how thoughtfully it is integrated into patient care. To help clinicians navigate this rapidly evolving landscape, the ACC continues to expand educational resources and strategic partnerships, including the AI-Enabled Clinician Podcast, ongoing collaboration with MedAxiom on AI-driven care transformation tools, the OpenEvidence partnership, and the growing AI Resource Center at ACC.org/AI.

"Well-designed technology can reduce duplication, surface risk, simplify communication, and allow clinicians to focus on judgment and relationships," says Le. "The key is to ask whether a new tool removes work or merely moves work onto someone else. Technology should support the human relationship and not become another barrier between patient and clinician."

Patient Access to Cardiology Care and Treatments

Throughout The Pitt, patients encounter obstacles that extend far beyond their medical diagnoses. Financial barriers, insurance requirements, treatment delays and social drivers of health often become as consequential as the conditions being treated.

These challenges are especially visible in cardiovascular care. Despite major advances in prevention, diagnosis and treatment, access remains uneven and continues to influence outcomes.

"Patients do not arrive at our doors with equal time, money, transportation, insurance coverage, health literacy, digital access, family support or trust in the health care system," says Le. "Two people may carry the same diagnosis but have very different chances of benefiting from the same recommendation."

Improving access will require innovation both inside and outside traditional care settings. Telemedicine, community-based screening initiatives, prevention programs and other outreach efforts offer opportunities to expand specialty care and identify cardiovascular disease earlier, particularly in underserved communities.

Within the health care system itself, care coordination remains essential. According to Le, successful transitions of care depend on timely follow-up, accessible patient education, clear communication among members of the care team and attention to social barriers that may affect treatment adherence.

Amy E. Simone, PA-C, FACC, chair of the ACC's Cardiovascular Team Section, emphasizes the importance of education and awareness.

"In many cases, the greatest disparity is not treatment itself, but awareness and access to timely diagnosis," she says. "Patients cannot seek care for symptoms or risk factors they do not recognize. We have to meet patients where they are, raise awareness of cardiovascular disease and create clearer pathways to care before a health crisis occurs."

Advocacy is also essential to advancing programs and policies that support patient access, prevention, community education and workforce capacity. Clinicians often witness firsthand the barriers patients face and can serve as powerful, trusted voices when meeting with lawmakers and other key decision makers.

"I would prioritize policies that remove avoidable barriers between patients and qualified clinicians," says Le. "That includes modernizing PA practice laws, reducing unnecessary administrative requirements, improving payment for prevention and care coordination, supporting telehealth and remote monitoring where appropriate, strengthening rural and community-based access, and improving coverage for evidence-based medications and services."

Workforce Pressures: When the System Is Stretched

Few themes in The Pitt resonate more strongly with cardiovascular professionals than the reality of working within an overstretched health care system. The series portrays clinicians caring for increasingly complex patients while managing staffing shortages, administrative burdens and limited resources.

Those same pressures are playing out across cardiovascular medicine.

"The workforce challenge in cardiology is showing up at every point in the care continuum," says Thomas Maddox, MD, MSc, FACC, who has led ACC workforce strategic efforts in recent years.

Patients are living longer and often require care from multiple specialists, while the teams responsible for coordinating that care are being asked to do more with limited resources. The result can be delayed access to appointments, imaging studies, procedures and follow-up care.

"When teams are overextended, the system naturally drifts toward episodic, reactive care," Maddox says. "That is hard on patients, and it is hard on clinicians."

Workforce shortages are often compounded by administrative complexity and technology-related demands. As teams become stretched, the resulting strain can affect access, continuity and clinician well-being.

"When staffing is inadequate, clinicians carry more cognitive and emotional load," says Le. "When workflows are fragmented, technology can add clicks without adding capacity. When teams are exhausted, access worsens and continuity suffers. Patients then return sicker, which further increases workload."

Many experts see team-based care as one of the most promising solutions. According to Maddox, successful cardiovascular programs increasingly rely on coordinated teams in which physicians, advanced practice providers, nurses, pharmacists, dietitians and care coordinators work together to manage complex patients.

Le agrees, noting that high-functioning multidisciplinary teams depend on "shared goals, clear roles, psychological safety, reliable communication and mutual respect." He emphasizes that every member of the cardiovascular team contributes expertise that expands the reach and effectiveness of care.

For Simone, the future of cardiovascular care depends on fully embracing that collaborative approach.

"No single clinician can meet the growing demands of cardiovascular disease alone," she says. "The strongest systems empower the entire cardiovascular team to work at the top of their expertise, support patients across the care continuum, and help every patient achieve the best possible outcome."

Addressing workforce challenges will require more than filling open positions. It will require rethinking how care is delivered, reducing unnecessary administrative burden, supporting long-term career development and building systems that enable clinicians to thrive – something the ACC remains committed to doing as part of its Strategic Plan.

"One of the lessons highlighted in The Pitt is that workforce challenges cannot be separated from the broader health care system," says Khandewal. "The ACC recognizes that reality. Whether through clinician well-being and culture initiatives, health equity efforts, leadership development, team-based care, digital transformation, advocacy, or collaboration with Chapters and partner societies, we are pursuing coordinated solutions that strengthen both the workforce and the care patients receive."

As cardiovascular medicine continues to evolve, the future of care will depend not only on scientific and technological advances, but also on creating environments where clinicians can thrive and patients can access the care they need. The Pitt may be fiction, but for many health care professionals, the realities it portrays are all too real.

Keywords: Cardiology Magazine, ACC Publications, CM-Sep-2026, Mental Health, Workforce, Health Services Accessibility, Health Care Quality, Access, and Evaluation, Digital Technology, Artificial Intelligence