Too few or too many dermatologists? Difficulties in assessing optimal workforce size

Discussions of the dermatology workforce have been dominated in the last 3 decades by concerns of an impending surplus. The aim of this article is to provide new data on the supply of dermatologists and to reassess estimates of future demand in light of growing anecdotal evidence suggesting a shortage. The US supply of dermatologists has risen to 3.3 per 100 000 population, and this growing workforce continues to be geographically maldistributed. A number of factors, including a possible increase in the number of surgical and cosmetic procedures being performed, might make this growing supply less available for the care of medical dermatology patients, complicating any supply projections. Precise estimates of future demand are also difficult because changes in disease prevalence, medical technology, and the health care delivery system are not always predictable. In an era when regulatory bodies are making more centralized decisions about residency training, the field must attempt to estimate and anticipate future needs. Simply allowing others to make decisions about the future size of the workforce based on outdated data risks an oversupply or undersupply, either of which will have detrimental effects on dermatologists and their patients.