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The general pediatrician: projecting future workforce supply and requirements
Scott A Shipman1, Jon D Lurie, David C Goodman
1Department of Pediatrics, Oregon Health and Science University, Portland, Oregon 97201, USA. shipmans@ohsu.edu
Insights
The number of general pediatricians is projected to significantly outpace child population growth by 2020. Future pediatricians may need to expand services or patient populations to maintain practice volumes.
Area of Science:
- Pediatrics
- Health Workforce Analysis
- Population Health
Background:
- Workforce assessments for child health physicians are being re-evaluated due to changing supply and demand.
- Previous analyses may not accurately reflect the current pediatric workforce adequacy.
Purpose of the Study:
- To project the national supply of practicing general pediatricians over a 20-year period (2000-2020).
- To assess the future pediatrician-to-child population ratio.
Main Methods:
- Developed a predictive model using data on the U.S. pediatrician workforce, residency graduates, and productivity.
- Incorporated demographic changes in the child population and care patterns with family practitioners.
- Analyzed time trends in pediatrician supply and the child population per pediatrician.
Main Results:
- The general pediatrician workforce is projected to increase by 64% (approx. 25,000 physicians) from 2000 to 2020.
- The child population is projected to grow by only 9% during the same period.
- Pediatrician supply is expected to grow substantially faster than the child population, contrasting with other primary care specialties.
Conclusions:
- The expansion of the general pediatrician workforce is unlikely to be significantly slowed by factors that might attenuate growth.
- Future pediatricians may need to broaden services, include young adults, or attract patients from non-pediatrician providers to maintain current practice volumes.
Objective:
Trends affecting both the supply and requirements of child health physicians call into question earlier assessments about the adequacy of the general pediatric workforce. To understand the effects of these trends over time, we developed a model that projects the national supply of practicing general pediatricians over a 20-year period (2000-2020).
Design:
The model incorporates current data on the practicing pediatrician workforce in the United States, pediatric residency graduates entering general pediatrics, and gender- and age-specific measures of productivity and of retirement or death. In addition, it accounts for projected changes in the size and ethnicity of the child population and the proportion of children currently receiving outpatient care from family practitioners.
Main Outcome Measures:
Time trend of the supply of general pediatricians and the number of children in the population per practicing pediatrician.
Results:
The baseline model projects that the number of general pediatricians will expand by nearly 25 000 by the year 2020, a 64% increase from the year 2000, whereas the child population is projected to expand by only 9%. The increase was robust to sensitivity analyses measuring the impact of each of the model's variables on the future supply of pediatricians. In all probable scenarios, the general pediatrician workforce will expand significantly more rapidly than the child population. In addition, the trend in pediatrics is in marked contrast to the other primary care specialties.
Conclusions:
Despite a number of factors that might attenuate the growth of the general pediatrician workforce, none seems sufficient to slow its expansion in relation to the pediatric population. To maintain practice volumes comparable to today, pediatricians of the future may need to provide expanded services to the children currently under their care, expand their patient population to include young adults, and/or compete for a greater share of children currently cared for by nonpediatricians.
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