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The changing supply of renal physicians
1American Medical Association, Policy Development Unit, Chicago, IL 60610, USA.
Summary
The number of renal physicians in the US grew significantly faster than all physicians, driven by international medical graduates. Projections show continued growth, but demand for nephrologists may be tempered by healthcare cost-containment measures.
Area of Science:
- Nephrology
- Healthcare Workforce Analysis
- Public Health
Background:
- In 1993, 4,355 active physicians specialized in adult or pediatric nephrology in the US.
- Renal physicians represented 0.8% of active physicians, with a ratio of 1.67 per 100,000 people.
- The nephrology workforce has grown substantially, outpacing overall physician growth.
Purpose of the Study:
- To analyze the growth trends of the renal physician population.
- To project the future supply of adult nephrologists under various scenarios.
- To assess the future demand for nephrology services.
Main Methods:
- Analysis of the American Medical Association (AMA) Physician Masterfile for 1970-1993.
- Projection modeling for adult nephrologist supply through 2010 based on different workforce scenarios.
- Examination of end-stage renal disease (ESRD) prevalence trends and demographic factors.
Main Results:
- The number of renal physicians increased over tenfold from 1970 to 1993.
- International medical graduates (IMGs) have increasingly entered nephrology residencies.
- Projected supply increases for adult nephrologists range from 62% to 134% by 2010, depending on policy and IMG trends.
- End-stage renal disease (ESRD) prevalence doubled between 1984 and 1993, indicating rising demand.
Conclusions:
- The nephrology workforce is projected to grow significantly due to past trends and IMG influx.
- Future demand for nephrologists is likely to increase, driven by ESRD prevalence and an aging population.
- Factors like managed care and cost-containment may influence long-term demand for nephrology services.