Temporal Trends and Practice Patterns in the Urology Work Force between Low and High Density Population Areas

Area of Science:

• Urology
• Healthcare Access
• Physician Workforce Analysis

Background:

• Understanding geographic variations in urologist supply and practice is crucial for evaluating access to urological care and potential workforce shortages.
• Quantifying differences between urban and nonurban urologists and analyzing trends over time is essential.

Purpose of the Study:

• To quantify differences in practice patterns between urban and nonurban urologists in the United States.
• To evaluate trends in the geographic distribution of urologists over time.

Main Methods:

• Utilized procedural case logs from the American Board of Urology (ABU) for 9,390 urologists certified between 2003 and 2015.
• Performed summary statistics to characterize practice patterns and case mix of nonurban (population <100,000) versus urban (population >100,000) urologists.

Main Results:

• The proportion of nonurban urologists decreased from 19.4% in 2003 to 14.2% in 2015.
• Nonurban urologists were more likely to be generalists, practice longer, be solo practitioners, and perform fewer major urological cases annually compared to urban urologists.
• A higher percentage of urban urologists were female.

Conclusions:

• A growing imbalance in the geographic distribution of urologists is evident.
• An aging nonurban urological workforce performing fewer major operations may lead to access barriers for Americans in nonurban areas.
• The findings highlight potential challenges in ensuring equitable access to specialized urological care across different geographic regions.