Urologic manpower issues for the 21st century: assessing the impact of changing population demographics

To evaluate the impact of changing population demographics on urologic staffing over the coming decades.

A model was constructed using data obtained from the U.S. Bureau of the Census for population projections; clinical studies to assess the percentages of men with symptomatic benign prostatic hyperplasia (BPH) and those undergoing prostatectomy; the American Medical Association regarding numbers and annual percent change of practicing urologists; and the American Urological Association regarding numbers of physicians completing residency training programs. Sensitivity analyses were performed varying both the rate of surgical intervention for symptomatic BPH and the annual increase in the number of practicing urologists.

Regardless of variations in the surgical rate to as low as 4%, the average number of transurethral resections of the prostate gland/surgical interventions for BPH per urologist will increase by the year 2020 when compared with the known basepoint value obtained for 1990. Additionally, even with an annual net increase of 200 urologists per year, by 2020, the rapidly expanding population over 65 years of age will nearly offset even such a large increase in the number of practicing urologists.

The greatest factor concerning future urologic staffing issues will be the changing population demographics. The need for urologic services will continue to rise. An oversupply of urologists can be avoided as long as the net increase does not exceed an average of 200 urologists annually.