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Published on: February 2, 2017
Child Health Needs and the Pediatric Endocrinology Workforce: 2020-2040
Tandy Aye1,2, Charlotte M Boney3, Colin J Orr4,5
1Division of Pediatric Endocrinology.
Insights
The US pediatric endocrinology (PE) workforce faces critical shortages due to aging providers, geographic disparities, and trainee concerns. Urgent action is needed to ensure adequate care for children with endocrine disorders.
Area of Science:
- Pediatric Endocrinology
- Medical Workforce Analysis
- Healthcare Policy
Background:
- The United States pediatric endocrinology (PE) workforce is currently insufficient to meet the growing demand for specialized care.
- Previous evaluations of the PE workforce have been updated to analyze current and future capacity and geographic distribution.
Purpose of the Study:
- To model the current and future clinical pediatric endocrinology workforce and its geographic distribution through 2040.
- To identify factors impacting PE workforce capacity, including demographics, training, and practice patterns.
Main Methods:
- Utilized a subspecialty workforce supply model projecting national, regional, and divisional headcount and clinical workforce equivalents through 2040.
- Incorporated data from the American Board of Pediatrics and the National Resident Matching Program.
Main Results:
- Identified significant challenges including an aging provider base, part-time appointments, and uneven geographic distribution.
- Noted factors affecting trainees such as limited exposure, financial concerns, and lifestyle perceptions.
- Highlighted the impact of complex cases, reliance on international medical graduates, research career focus, and recent policy changes on gender-affirming care.
Conclusions:
- The PE workforce faces multifaceted challenges that diminish capacity and affect geographic distribution.
- Proactive strategies in education, training, clinical practice, and policy are essential to address current and future workforce needs.
- Future research is needed to further understand and mitigate workforce challenges in pediatric endocrinology.
Abstract:
The pediatric endocrinology (PE) workforce in the United States is struggling to sustain an adequate, let alone optimal, workforce capacity. This article, one of a series of articles in a supplement to Pediatrics, focuses on the pediatric subspecialty workforce and furthers previous evaluations of the US PE workforce to model the current and future clinical PE workforce and its geographic distribution. The article first discusses the children presenting to PE care teams, reviews the current state of the PE subspecialty workforce, and presents projected headcount and clinical workforce equivalents at the national, census region, and census division level on the basis of a subspecialty workforce supply model through 2040. It concludes by discussing the educational and training, clinical practice, policy, and future workforce research implications of the data presented. Data presented in this article are available from the American Board of Pediatrics, the National Resident Matching Program, and the subspecialty workforce supply model. Aging, part-time appointments, and unbalanced geographic distribution of providers diminish the PE workforce capacity. In addition, limited exposure, financial concerns, and lifestyle perceptions may impact trainees. Additional workforce challenges are the subspecialty's increasingly complex cases and breadth of conditions treated, reliance on international medical graduates to fill fellowship slots, and high relative proportion of research careers. The recent limitations on pediatric endocrinologists providing gender-affirming care may also impact the geographic distribution of the subspecialty's workforce. Deliberate actions need to be taken now to continue serving the needs of children.
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