The coming years will see continued growth in the epidemic of heart failure and increasingly complex pharmacologic, interventional, and device-based therapies effective in reducing heart failure morbidity and mortality. Highly trained clinician-specialists are needed to assist in optimally evaluating and managing patients with heart failure. The patient is the central element defining the skills needed within this cardiology subspecialty. Primary care education, disease management strategies, and effective communication among heart failure specialists and other clinicians are key systemic elements needed to deliver the increasingly complex array of treatments to the expanding population of patients with heart failure.