I'm definitely aware of the shortage issue. I think the problem is that a cardiologist offers a certain level of expertise that requires a certain catchment area. So the more remote you go, the farther north you go, generally there won't be enough patient population to allow you to continue to function as a cardiologist full time. I am aware of some colleagues who still wanted to choose that lifestyle, so they have gone as cardiologists, but they tend to function more as general internists. They fall back to some of the skill sets they had in other branches of internal medicine, like GI or respirology.
The issue with offering cardiology services remotely is that it has to be done through this sort of remote two-way technology. For example, I could run a clinic one day a week somewhere very remote. I could do stress tests, because there would be a trained technologist there, and I would be there not only in the two-way audio and visual approach, where I can see the patient and I can see what's happening on the treadmill, but also ideally I would see the telemetry on my computer screen as it was being sent to me remotely.
Likewise I could do a consult, in which I would spend maybe 15 minutes discussing with the patient. Then I would be able to have an echocardiogram done, again by a skilled technologist, and I would actually see the images on my screen, because there's no reason that information couldn't be transferred digitally.
I think the biggest hurdle to having cardiac services out there isn't getting cardiologists there, but making sure that the adequate infrastructure is available so that the expertise can be used. I'd say stress tests and echocardiograms provide a lot of what we need to offer.