The clinical endocrinology workforce: current status and future projections of supply and demand
Robert A Vigersky1, Lisa Fish, Paul Hogan
1Diabetes Institute (R.A.V.), Walter Reed National Military Medical Center, Bethesda, Maryland 20889; Hennepin County Medical Center (L.F.), Minneapolis, Minnesota 55425; The Lewin Group (P.H.), Falls Church, Virginia 22042; Diabetes, Obesity, and Metabolism Institute (A.S.), Mt Sinai School of Medicine, New York, New York 10029; The Endocrine Society (S.K.), Washington, DC 20036; Division of Endocrinology and Metabolism (P.W.L.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205; Endocrinology and Diabetes Practice (M.M.), University of Colorado Hospital, Denver, Colorado 80045; and Division of Endocrinology, Diabetes, and Metabolism (K.H.H.), Nassau University Medical Center, East Meadow, New York 11554.
Context:
Many changes in health care delivery, health legislation, and the physician workforce that affect the supply and demand for endocrinology services have occurred since the first published workforce study of adult endocrinologists in 2003.
Objective:
The objective of the study was to assess the current adult endocrinology workforce data and provide the first analysis of the pediatric endocrinology workforce and to project the supply of and demand for endocrinologists through 2025.
Design:
A workforce model was developed from an analysis of proprietary and publicly available databases, consultation with a technical expert panel, and the results of an online survey of board-certified endocrinologists.
Participants:
The Endocrine Society commissioned The Lewin Group to estimate current supply and to project gaps between supply and demand for endocrinologists. A technical expert panel of senior endocrinologists provided context, clinical information, and direction.
Main Outcome Measures:
The following were measured: 1) the current adult and pediatric endocrinology workforce and the supply of and demand for endocrinologists through 2025 and 2) the number of additional entrants into the endocrinology work pool that would be required to close the gap between supply and demand.
Results:
Currently there is a shortage of approximately 1500 adult and 100 pediatric full-time equivalent endocrinologists. The gap for adult endocrinologists will expand to 2700 without an increase in the number of fellows trained. An increase in the prevalence of diabetes mellitus further expands the demand for adult endocrinologists. The gap can be closed in 5 and 10 years by increasing the number of fellowship positions by 14.4% and 5.5% per year, respectively. The gap between supply and demand for pediatric endocrinologists will close by 2016, and thereafter an excess supply over demand will develop at the current rate of new entrants into the work force.
Conclusions:
There are insufficient adult endocrinologists to satisfy current and future demand. A number of proactive strategies need to be instituted to mitigate this gap.
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