Hello again, cwbrd!
I wish there was more statistical information available concerning
the job outlook projections for the physician specialties you have
highlighted in your question. As I stated in my clarification, the
only way to form a picture of the current job situation and future
occupational outlook for each specialty is to wade through heaps of
articles to find the few tidbits of information available!
I have compiled the following information for each specialty,
including those excerpts from my clarification, so that it is all
together if you need to print it out.
**
On another note, I would be happy to look into further questions of
this nature if you decide to follow up with more. Simply put "For
Umiat" in the title so that I will be sure to see the question. If I
am not able to provide an answer, I will certainly make sure to leave
the question open for other researchers.
You have also asked my thoughts about the price offered for the
research involved in answering a question of this type. Unfortunately,
$200 is the highest amount allowed for pricing a question, of which a
researcher gets 75%. ($175.00) Tipping is also allowed up to $200.
Admittedly, this question was difficult due to the lack of information
on the sub-specialties you requested. Most of the time involved was
spent wading through articles and search results that lacked specific
data. However, should you ask a similar question in the future,
information about different specialties might be easier to find. I do
agree that this type of question merits the hightest price due to the
number of hours required to perform an adequate search.
**
With that said, here you go! I hope the following references prove helpful.
**************
HOSPITALISTS
**************
"How many Hospitalists are practicing today? -Because many
Hospitalists operate at a local level - one or two doctors at one
hospital - it has been difficult to get an exact handle on the number.
However, it is estimated that there are between 7,000 - 8,000
practicing Hospitalists today, with the number expected to grow to
20,000 in the next decade. SHM is completing its Universe Project in
2003 in an effort to define the true census of American Hospitalists."
From a fact sheet on the Society of Hospitalist Medicine website:
http://www.hospitalmedicine.org/presentation/apps/indlist/intro.asp?area=mediacenter&flag=14
==
"The number of hospitalists nationwide went from 200 or so in 1992 to
around 5,000 in 2002, according to the Society of Hospitalist
Medicine. Projections are that the number will reach 20,000 by 2010.
That's roughly the same number of cardiologists in the country now,
Slataper says."
From "There is a doctor in the house - 'Hospitalists' let office-based
docs get down to business and hospitals run smoother," by Steve Clark,
Business Report staff.
http://www.daily-report.com/newsDetail.cfm?aid=59&cid=25
==
"The number of hospitalists has grown from a few hundred in the
mid-1990s to about 7,000 today, Wellikson said, with about 89 percent
of hospitalists specializing in internal medicine. According to some
health professionals, that number is expected to grow to 20,000
hospitalists by 2010. The numbers are more striking in states like
California and Massachusetts, where hospitalists have been around the
longest. The NAIP just completed a survey in Massachusetts and found
that 42 percent of hospital patients are being managed by
hospitalists. In the next few years Massachusetts hospitals expect
more than 60 percent of patients to be cared for by hospitalists,
Wellikson said."
"Those numbers would mean a big change in the traditional way
primary-care physicians interact with their patients. "It's not the
same as what everybody has been used to in the community," said Nash.
"But it gives primary-care physicians a chance to keep up on the
latest technologies and care methods."
From "Bedside matters - More doctors becoming hospitalists," by Kyle
Gearhart. Wausau Daily Herald. Nov. 3, 2002.
http://www.wausaudailyherald.com/wdhbusiness/277163355758663.shtml
==
"According to the National Association of Inpatient Physicians, a
professional organization, there are about 7,000 physicians working as
hospitalists, and the demand is rising.
"We know by the end of this decade we can expect more than 20,000
hospitalists," said Larry Wellikson, a physician and executive
director of the association.
"Primary care physicians, surgeons and internists are willing to give
up the inpatient care, and it makes sense to have someone in the
hospital all the time to do that."
From "HOT JOBS: Hospitalists," by Ruth Baum Bigus. Kansas City Star.
Feb. 23, 2003. http://www.kansascity.com/mld/kansascity/business/5218214.htm?1c
==
(Older statistics)
"NAIP (the professional organization for hospitalists) is an affiliate
of the American College of Physicians. Having grown from 23 members to
more than 1500 members in the past three years, NAIP is undoubtedly
the fastest-growing professional medical society. An estimated 4000
hospitalists currently practice in the United States, and a need for
19,000 is likely to develop if hospitalists become the predominant
providers of adult inpatient care."
From "Hospitalist Practice: An Increasingly Popular Model for
Inpatient Care," by Diane Craig, MD. The Permanente Journal. Spring
2001
http://xnet.kp.org/permanentejournal/Spring01/Hospitalist.html
***************
NEONATOLOGISTS
***************
The little amount of information concerning projections for
neonatologists suggests that there is currently no shortage.
=
"On the contrary, certain practice trends in pediatrics may exacerbate
the effects of a growing supply of general pediatricians....In
addition, the expansion of the supply of neonatologists and
hospitalists will lead to fewer hospitalized patients and newborns for
general pediatricians to care for."
From "The general pediatrician: projecting future workforce supply and
requirements," by by Scott A. Shipman, Jon D. Lurie, David C. Goodman.
Pediatrics, March, 2004.
http://www.findarticles.com/p/articles/mi_m0950/is_3_113/ai_114591502/pg_3
==
"During the last 30 years, there's been an explosion in the number of
neonatal intensive care units and neonatologists in the United States.
But the growth has been uneven, with some regions of the country
accruing more than four times the number of neonatal beds and
neonatologists -- pediatricians with extra training to care for ill
newborns -- than other areas."
"The explosion and uneven distribution of neonatal resources is
largely the result of market forces, as more hospitals have added
prestigious -- and often lucrative -- neonatal units, the Dartmouth
researchers say....."We can do all that we want in neonatal intensive
care, but we have a fundamental problem we haven't really addressed,"
Goodman says. "Should [neonatologists] be ever-growing when we have
these well-recognized unmet needs that are sometimes more
fundamental?"
From "Neonatal care in U.S. doesn't reflect the needs," by Amanda
Gardner. HealthScoutNews. May 2002.
http://kmbc-tvhealth.ip2m.com/index.cfm?PageType=itemDetail&Item_ID=61950&Site_Cat_ID=46
==
"The growing number of pediatricians trained to treat frail newborns
has helped reduce infant death rates over the past 30 years, but a new
study suggests that in many areas of the country the number of
neonatologists is far more than needed. Researchers writing in today's
New England Journal of Medicine say that they found that increasing
the supply of neonatologists made relatively little difference in the
death rates for infants."
"The downside of having too few providers is obvious. But too many
doctors or ICUs for newborns also can lower quality, the researchers
suggested, because providers might not treat enough patients annually
to develop and maintain their expertise. The study, led by Dr. David
Goodman of Dartmouth Medical School, which categorizes the supply of
neonatologists in each region as very low, low, medium, high and very
high, identifies the Pittsburgh region as having a low supply and
Philadelphia as having a very high supply."
"Those supplies vary greatly, from an average of 2.7 doctors for every
10,000 births in areas with a very low supply of neonatologists, to
11.7 physicians per 10,000 births in the areas with a very high
supply. The researchers said the differences could not be explained by
differences in the number of very premature infants or differences in
risk factors."
"Money has more to do with the supply of neonatologists than need
does, said Dr. Kevin Grumbach, a health workforce researcher at the
University of California, San Francisco. Neonatologists make more
money than other pediatricians, he noted, and newborn ICUs are profit
centers for hospitals"
From "Oversupply of doctors for high-risk newborns," By Byron Spice,
Science Editor, Post-Gazette. May 16, 2002
http://www.post-gazette.com/healthscience/20020516neonate0516p2.asp
==
"Thompson's study, which was published in Pediatrics, compared the
whole spectrum of neonatal care in the U.S.--from pregnancy to birth
to specialized care after birth-- with that of three other countries:
Canada, Australia, and the United Kingdom. She found that the U.S. has
far more neonatal intensive-care resources, puts less emphasis on
prenatal care, and has a lot more lowbirth- weight, at-risk babies.
The other three countries have fewer neonatal resources, put more
emphasis on prenatal and reproductive care, and have a lot fewer
at-risk babies.
Of the four countries, the U.S. has 40% more neonatologists than the
next-best-staffed country, Australia, even after accounting for the
greater number of high-risk babies. The U.S. has 8.0 neonatologists
per 1,000 lowbirth- weight births, whereas Australia has 5.7, Canada
has 5.5, and the United Kingdom has 3.7. But neonatal mortality rates
are about the same in all four countries; the U.S., with more
resources, does no better.
"It really challenges our kind of current health-care system, which is
expanding neonatal intensive care," says Thompson, an instructor in
pediatrics. "It looks to me that we probably don't need to expand it
anymore."
From "In neonatal care, is more too much of a good thing?," by Matthew
C. Wiencke. Dartmouth Medical School. Fall 2002.
http://www.dartmouth.edu/dms/news/publications/dartmed/fall02/html/vs_neonatal.shtml
==
(from a 1998 study)
Background: "The efficiency and access to existing perinatal resources
has become a focus of debate. Despite inconsistent references to the
number of neonatologists and unsubstantiated personnel requirement
recommendations, recent commentaries have suggested a current 30% to
50% excess in workforce."
Read "United States Neonatology Practice Survey: Personnel, Practice,
Hospital, and Neonatal Intensive Care Unit Characteristics," by Louis
D. Pollack*, Ian M. Ratner, and Greg C. Lund. PEDIATRICS Vol. 101 No.
3 March 1998, pp. 398-405.
http://pediatrics.aappublications.org/cgi/content/full/101/3/398
==
The following overview is from Neonatology on the Web:
How Many Neonatologists Are There?
"According to a workforce report from the American Academy of
Pediatrics in October 1996, there were at that time 3688
board-certified and board-eligible neonatologists in the USA.
Approximately 75% were board-certified and 25% had not yet taken or
had not passed the neonatology board exam. Of the 3688, about 92% were
actually practicing neonatology, and 56% were working as
neonatologists full-time. Although these statistics are several years
old, they are still useful because the neonatology job market is very
stable."
"A workforce analysis in the December 2000 issue of Pediatrics
("Providing Pediatric Subspecialty Care: A Workforce Analysis,"
Pediatrics 106(6):1325-1333, December, 2000) provided the following
demographic information based on a survey sent to 2922 neonatologists,
with a 70% return rate:
Average age: 47
Average years since graduation from medical school: 21
Average expected age of retirement: 63
Gender: 65% male, 35% female
Ethnic background: 70% Caucasian
"There were 102 active 3-year neonatology training programs in the USA
as of June 1998, with approximately 150 physicians in each year of
training."
From "A Career in Neonatology - Information for Students and
Teachers." Created 8/1/99 / Last modified 6/19/2003
http://www.neonatology.org/career/
***************
PULMONOLOGISTS
***************
"By the year 2007, the world will be a different place. Perhaps it
will be a better world with people living longer. Maybe there will
even be a cure for AIDS. But it may also be a worse world, complete
with shortages of caregivers, including a shortfall of pulmonologists.
Three highly regarded associations - the American Thoracic Society,
ACCM and ACCP - are already predicting severe shortages in that
field."
"Two of the busiest areas in medicine today are care of the critically
ill and management of pulmonary disease. These two areas are also the
most likely to be profoundly influenced by increases in the number of
elderly patients in the years ahead."
"It may get worse before it gets better," concluded George G. Burton,
MD, senior pulmonologist at Kettering Medical Center, Kettering, Ohio.
That does not mean it is a hopeless situation. "Respiratory care
professionals can step up and help the pulmonologist by acting as
physician extenders. If we wait for pulmonary physicians in training,
we will be waiting a very long time," he added."
Pulmonologists and physicians in general are retiring earlier, leaving
a lot of work hanging in the balance. "A lot of the physicians I know
are retiring because of the stress involved," said Burton who is still
working at age 68 because "there is still so much work to do."
"Doctors encounter problems with the pulmonary care field even as they
get set to embark on their careers. Doctors undergo years of training
and pile up a mountain of debt before they even launch their
practices. To defray some of the cost, they rely on fellowships, but
these are difficult to obtain even though the budget for the National
Institute for Heart, Lung and Blood has gone up. As a result, "there
has not been enough money to train these people," Burton said."
"Fast forward five years, and this is what we can expect. "There will
be a shortage of pulmonary experts in 2007 because of the aging
population," said Marchant Wentworth, director of Health Care Policy
for the American Thoracic Society (ATS). It takes about seven years to
build a specialist, and currently there are few people stepping to the
plate."
"Where are these intensivists going to come from?" Wentworth wondered.
"People are completely stressed out and overworked now in the ICU.
There is just no way for them to be instantly produced. We need to
take action to train more intensivists."
Read further...
From "Where Have All the Pulmonologists Gone?" by Caroline Crispino.
Advance for Respiratory Care Practitioners.
http://respiratory-care.advanceweb.com/common/editorial/editorial.aspx?CC=3386
==
From the Thoracic.org website:
"There is a critical shortage of Pediatric Pulmonologists."
"There are fewer than 1,000 board certified Pediatric Pulmonologists
in the United States. Therefore, there is a tremendous shortage of
subspecialists in both academic medicine and in private practice.
Thus, employment opportunities abound for the Pediatric Pulmonologist.
Most Fellows graduating from accredited programs in the U.S. have an
option of choosing between several academic and/or private practice
jobs. Many U.S. medical schools still have no Pediatric Pulmonologist.
Those medical schools and private practices who have Pediatric
Pulmonologists want more. Therefore, it is likely that there will be
more demand than available subspecialists for several years to come."
See "Fellowship Training in Pediatric Pulmonology," by Thomas G. Keens, M.D.
http://www.thoracic.org/fellows/pedpulm.asp
==
PULMONOLOGISTS WILL BE LOST MOSTLY TO ATTRITION
"The study found a similar pattern for pulmonologists, although a
shortage in their services is likely to occur before 2007 because
retirees from pulmonary medicine are expected to outnumber new
graduates. This shortage will be even more severe than the one
predicted for intensivists, reaching 35% by 2020 and 46% by 2030,
according to the authors? projections."
From "PHYSICIAN SHORTAGE LOOMS IN PULMONARY AND CRITICAL CARE."
Pulmonary Reviews.com (2001)
http://www.pulmonaryreviews.com/apr01/pr_apr01_shortage.html
==
"The authors also found supply and demand for pulmonologists, the
specialty that has the strongest crossover with CCM medicine, in rough
equilibrium during 1997-99. They predicted shortage conditions in that
market would appear by the early 2000s, and grow to a 35% shortage by
2020 and a 46% shortage by 2030."
From "Growing Population of Seniors Spurs Critical Care Shortage."
Physician Compensation Report, June, 2002.
http://www.findarticles.com/p/articles/mi_m0FBW/is_6_3/ai_87799049
==
"The immediate past Chair of the ATS Council of Chapter
Representatives, Dr. Stewart advocates for the need to develop
training programs and a larger pool of pulmonologists in the trenches.
"There is a huge shortage looming in pulmonary and critical care
medicine," Dr. Stewart says. "There may be as much as a 50 percent
shortfall in pulmonary physicians by the year 2020. The problem goes
back to a document published about 15 years ago by the federal
government, based on inaccurate data, which said that there were too
many specialists and too few family practitioners. That led to cuts of
25 percent in specialty fellowships - we need those slots back."
From "Who?s Who in ATS. George L. Stewart, M.D." ATS News. June 2004,
Vol. 30, No. 6
http://www.thoracic.org/cgi-bin/showfile.pl?news/atsnews/news0604/story7.asp
==
"In Wednesday's Journal of the America Medical Association, Kelley and
four colleagues report that the number of pulmonologists and doctors
who specialize in intensive care will decline slightly by 2030. But
demand for such services is projected to rise 66 percent for intensive
care doctors and about 50 percent for pulmonologists."
From "PHYSICIAN SHORTAGE PREDICTED," by Seth Borenstein. Miami Herald.
Dec. 10, 2000.
http://fig.cox.miami.edu/~cmallery/150/webstories/physician_shortage.htm
==
(From a December 6, 2000 article in the Journal of the American
Medical Association):
"In the first study of its kind to include aging baby boomers in its
results, researchers today predicted demand for medical services
provided by critical care and pulmonary medicine specialists will
outpace the future supply of these doctors by 2007."
"According to the study, critical care specialists today provide care
to about 37 percent of all intensive care unit (ICU) patients. Since
Medicare enrollment is predicted to grow by more than 50 percent over
the next 30 years, this study estimates a shortfall of critical care
specialists equal to 22 percent of patient demand by 2020 and 35
percent by 2030."
* "A shortage of pulmonary specialist time will also rise to 35
percent by 2020 and 46 percent by 2030."
"With regard to the number of U.S. intensivists trained, there were
354 graduates during 1996 from pulmonary and pulmonary/critical care
medicine programs, 110 graduates from internal medicine critical care
programs, 67 graduates from surgical critical care programs, and 63
graduates from anesthesiology critical care programs."
"The study points out that, after 2007, with no special circumstances
considered other than the growing number of aging baby boomers, demand
rises rapidly while supply remains near constant."
"The study points out that, after 2007, with no special circumstances
considered other than the growing number of aging baby boomers, demand
rises rapidly while supply remains near constant."
From "JAMA STUDY SHOWS AGING BABY BOOMERS TO CAUSE TREATMENT DEMAND
PINCH IN CRITICAL CARE UNITS." December 5, 2000 (American Thoracic
Society News)
http://www.thoracic.org/news/jama.asp
"The pulmonologist shortfall develops sooner because the current
workforce is anticipating retirement at a rate faster than the
graduation rate. The shortfall in pulmonologist hours is predicted to
be 35 percent by 2020 and 46 percent by 2030."
************
ONCOLOGISTS
************
"The cancer treatment needs of the aging baby boom generation may
create a crisis in the oncology work force, according to James L. Wade
III, M.D., president of the Association of Community Cancer Centers.
And oncologists may not be the force to solve the dilemma.
"An estimated tally of medical oncologists -- roughly 1.8 full-time
equivalent medical oncologists per 100,000 U.S. adults -- may be
adequate for right now, said Wade, "but I think that the work force is
probably inadequate to meet the growing need over the next 10 years."
He said the situation could be exacerbated if experienced oncologists,
tired of health care delivery system hassles, decide to retire early."
"A study comparing the American Society of Clinical Oncology's figure
above to the numbers published by health maintenance organizations
suggests that "we have a reasonable supply [of oncologists] at this
time," said Wade. But, he noted, as the country faces the year 2000,
the projected need for specialists in the United States is 3.6
oncologists/hematologists per 100,000 U.S. adults -- about twice as
many as there are now. The study was published by the Graduate Medical
Education Advisory Committee.
"Wade added that "our technology is not going to remain static; we
will have more to offer, so I predict that the 3.6 per 100,000 will be
a low figure." He also questioned whether training approximately 180
new medical oncologists per year -- as is now done -- will produce
enough new oncologists to meet the growing demand."
From "Non-Physician Providers May Ease Oncology Work Force Crisis."
Journal of the National Cancer Institute. Vol. 90, No. 8 > Eastman,
pp. 567-569
http://jncicancerspectrum.oupjournals.org/cgi/content/full/jnci;90/8/567
==
"The Society of Surgical Oncology identifies only 1,200 active
surgeons in the U.S. whose surgical oncology training satisfies the
Society?s minimal criteria. By comparison, the American Society of
Clinical Oncology boasts a membership of more than 18,000. Of these,
only six percent list surgical oncology as their primary specialty.
The shortage of academic surgical oncologists is exacerbated by recent
technological surgical advances, such as sentinel node mapping,
developed by JWCI?s Medical Director, Donald L. Morton, M.D."
From a description of John Wayne Cancer Institute's Surgical Oncology
Fellowship Program. http://www.jwci.org/Fellowships.htm
==
"There may be a shortage developing in the field. Practice managers --
nearly all of whom interviewed for this article are recruiting now or
recently hired someone -- report that recruiting is difficult, but
eventually it can be done. Fenster says there are forecasts that in 10
years there will be only about half the needed oncologists. The
underlying demand is rising very rapidly as the population over 50
soars, while the number of fellowship grads is rising slowly
Recruiter Chuck Corbett of Davis Smith in Southfield, Mich., says part
of the oncologist supply problem is that the specialty is hard
psychologically, and so demands people with the personality to handle
it. "It's frustrating when you're doing your best and a fair number of
your patients still don't make it," he says.
From "Oncologist Pay Ranges From Production to Equal Shares."
Physician Compensation Report, Jan, 2002.
http://www.findarticles.com/p/articles/mi_m0FBW/is_1_3/ai_81625822
==
1996 estimates:
CONCLUSION: "The medical oncology community devotes the majority of
its time to providing oncologic patient care and does not provide or
appear to wish to provide what the public defines as primary care. The
survey estimate of 1.8 medical oncologists per 100,000 adult Americans
is in close accord with HMO estimates of the number of desired
oncologists. Consequently, the supply appears consistent with the
anticipated demand. There does not appear to be an oversupply of
medical oncologists in the United States."
From "Status of the medical oncology workforce. The American Society
of Clinical Oncology." Journal of Clinical Oncology, Vol 14, 2612-2621
http://www.jco.org/cgi/content/abstract/14/9/2612
**************
NEPHROLOGISTS
**************
"If the ESRD annual growth rate continues to increase at 9% (current
rate), then an estimated 6,400 additional nephrologists will b
necessary in 10 years. This would require a three-told increase in the
current number of nephrologists in training (Ad Hoc Committee, 1997)."
From "Advanced Practic Nurses: Roles in the Hemodialysis Unit," by
Carol M. Headley and Barry Wall. Nephrology Nursing Journal. April
2000. Vol.27 No. 2
http://www.edtna-erca.it/archivio/Periodici/NephrologyNursingJournal/advanced%20practice%20nurse%20in%20HD.pdf
==
"End-Stage Renal Disease (ESRD) is a major and growing public health
issue. The number of people in the US requiring maintenance dialysis
or kidney transplantation reached nearly 380,000 in 2000. The
estimated cost to the Medicare ESRD Program for treating these
patients was $13.8 billion while non-Medicare spending was estimated
at an additional $5.5 billion.1 Furthermore, the number of patients
is projected to increase by about 75% to exceed 660,000 by 2010.2 How
the healthcare system will meet the costs of treating this number of
patients is unclear.
* It has also been estimated that a 28% increase in the number of
nephrologists will be needed to meet the demand by 2010." (3)
From "Improving Renal Care Through Pre-ESRD Education and Home Therapy
Options," By John Moran, MD. August 2003.
http://www.ikidney.com/iKidney/InfoCenter/Library/CDN/Archive/Pre-ESRD0803.htm
==
"Current trends in recruiting and training new nephrologists, coupled
with the projected growth in the ESRD patient population, indicate a
critical shortage of nephrologists by 2010. The current ration of one
nephrologist for every forty to sixty ESRD patients will increase to
one nephrologist for up to 120 patients."
From "Medicare's End-Stage Renal Disease Program: Current Status and
Future Prospects," by Allen R. Nissenso and Richard A Rettig. Health
Affairs. (Jan/Feb 1999)
http://content.healthaffairs.org/cgi/reprint/18/1/161.pdf
==
"Chronic kidney disease (CKD) - affecting approximately 20 million
Americans - has reached epidemic proportions, and the number of people
in the United States who go on to develop kidney failure has doubled
each of the last two decades. This trend is likely to continue,
leaving nephrologists with too many patients to manage alone."
"Anticipating the shortage, nephrologists are turning to primary care
providers (PCPs) for help. PCPs make logical partners since they
usually are the first to see kidney patients."
From "Renal Physicians and NIH Release Web Tool to Coordinate Care for
Kidney Patients." NIH News Release, June 8, 2004.
http://www.nih.gov/news/pr/jun2004/niddk-08.htm
==
(No actual numbers)
"As many of you are aware, in 1996 a consultant, Abt Associates, Inc.
of Bethesda, Maryland, was engaged to provide an assessment of the
nephrology workforce. That initial report, Estimating Workforce and
Training Requirements for Nephrologists through the Year 2010, was
updated in 2001. This extensive study and analysis concluded that the
requirements for nephrologists would grow significantly through the
year 2010. This conclusion was largely based on the estimates of
patients with end-stage renal disease (ESRD), the treatment of which
currently consumes the largest portion of nephrologists? professional
time devoted to clinical practice. The total number of ESRD cases has
been growing at a rate of about 12% per year, reflecting both a growth
in the prevalence of ESRD and the overall growth of the general
population."
(Read further)
"Since the study was completed in 1996, however, new data have become
available about the prevalence of early kidney disease, which is
estimated to affect at least 11 million individuals in the United
States. As these individuals are evaluated and diagnosed, it is
expected that a large portion of them will be referred to
nephrologists for ongoing care and medical management, a development
that will clearly overwhelm the current supply and time capabilities
of practicing nephrologists.
It is believed that the supply of nephrologists in the United States
has not changed substantially since 1996. The number of ESRD patients
continues to increase, and nephrologists are now faced with the
potential addition of early kidney disease patients to "at capacity"
caseloads. Joint discussions between the leadership of the ASN and
other renal-related organizations raised the question of whether a new
nephrology workforce study should be conducted..."
From "Potential for Updated Workforce Study in Nephrology." Am Soc
Nephrol 13:A31-A32, 2002.
http://www.jasn.org/cgi/content/full/13/10/A31
==
Also see the following articles:
"The changing supply of renal physicians," by Kletke PR. Am J Kidney
Dis. 1997 May;29(5):781-92.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9159317&dopt=Abstract
"Aging population drives demand for nephrologists." The Reporter.
Vanderbilt Medical Center. April 18, 1997
http://www.mc.vanderbilt.edu/reporter/?ID=215
******************
ANESTHESIOLOGISTS
******************
"There's a nationwide shortage of 1,300 to 3,800 anesthesiologists, or
from 3.5% to 10.5% of the current supply of active anesthesiologists.
The shortage will last at least until 2010, and, depending on future
conditions, may persist well beyond 2015. And this in turn suggests
that annual pay for anesthesiologists will keep soaring."
"So says an article in the October 2001 Mayo Clinic Proceedings. While
some may argue with specific parts of the methodology, the four
authors -- all Ohio anesthesiologists led by Armin Schubert, M.D., of
the Cleveland Clinic Foundation -- used many data sources and rigorous
statistical projection techniques."
From "It's Official: There's a Shortage Of Anesthesiologists for 10+
Years." Physician Compensation Report, Dec, 2001.
http://www.findarticles.com/p/articles/mi_m0FBW/is_13_2/ai_80616767
==
RESULTS: "Our model suggests that there is currently a 3.6% to 10.9%
shortage of anesthesiologists nationwide, depending on the assumption
of a 2% or 3% increase in annual demand since 1994 and a constant
pattern of work distribution by anesthesia providers. This amounts to
approximately 1200 to 3800 anesthesiologists. If projected demand
continues to increase at the rate of 1.5% to 2% annually, the
shortfall will amount to 2.6% to 12.0% of the labor supply by 2005,
representing a deficit of 1000 to 4500 anesthesiologists. By 2010,
this shortfall is projected to disappear or continue to amount to
about 11% of the anesthesiologist supply, depending on the assumptions
about the rate of demand for anesthesiologists. Compared with the
expected graduating class of 1100 anesthesiology residents in 2001,
our model calls for nearly 1600 graduates by 2005 and 2000 by 2010."
From "Evidence of a current and lasting national anesthesia personnel
shortfall: scope and implications." Schubert A, Eckhout G, Cooperider
T, Kuhel A. Mayo Clin Proc. 2001 Oct;76(10):995-1010.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11605702
=
Also see "Where Have All the Anesthesiologists Gone? Analysis of the
National Anesthesia Worker Shortage," by Gifford Eckhout, M.D. and
Armin Schubert, M.D. ASA Newsletter. April 2001. Volume 65
http://www.asahq.org/Newsletters/2001/04_01/eckhout.htm
*************
PATHOLOGISTS
*************
While there is an abundance of information concerning the shortage of
pathologists in other countries (Canada, the UK, Australia) there is
very little pertaining to either a shortage or overabundance of
pathologists in the U.S. What little information I could unearth,
follows.
According to the American Society for Clinical Pathology - "There are
approximately 12,000 board certified pathologists in the U.S. who
practice their specialty in community, university, and government
hospitals and clinics, in independent laboratories, or in private
offices, clinics, and other health care facilities."
http://www.ascp.org/general/pub_resources/pathologist.asp
==
"Pathologists face difficult times. Workload is up, reimbursement is
down and pressures of managed care keep increasing."
"Jerry Garvin, M.D., Ph.Dl, President of the Association of Pathology
Chairs, Inc., made the following predictions for the future of
Pathology for the year decade ahead in the APC Newsletter #118,
December 1999:
1. "There will soon be a shortage of Pathologists. Forget the manpower
studies and the follow-up on senior residents looking for positions.
Fewer U.S. graduates are choosing Pathology and the demands for the
services keep increasing. This trend will continue until it is
discovered that we have a true shortage. This will occur as students
realize the limitations of primary care as a career, and the political
influences that have steered them in that direction."
(See Point 2 and 3)
From "Pathology at the Crossroad." Department of Pathology and
Laboratory Medicine. The University of Texas. Issue #4, January 2000.
http://dpalm.uth.tmc.edu/admin/newsletter/newsletter2000-01.pdf
==
As pointed out in my initial clarification, the cry for Pathologist
Assistants indicates a possible shortage:
** "We are producing fewer pathologists than we used to, which is
fueling the need for pathologists' assistants," he said. "And, I
expect national certification to increase our visibility and possibly
create additional demand."
From "The American Association of Pathologists' Assistants Joins the
ASCP Board of Registry to Offer New Certification." US Newswire.
10/4/2004
http://releases.usnewswire.com/GetRelease.asp?id=37426
==
The army is currently using telepathologists to compensate for a
shortage of pathologists:
"The Army now has a shortage of pathologists and using telepathology
enables pathologists to do more with less, while improving the quality
of patient care."
"The Army has found that telepathology can serve patients more
effectively over a shorter time span and saves money in shipping
costs, paperwork, and the personnel needed to ship slides to the
various institutions."
"To date, the army has done over 150 cases using remote telepathology.
The Armed Forces Institute of Pathology continues to do cases on a
regular basis with Fort Knox, Bragg, Landstuhl and Tripler medical
centers. Plans are to deploy another 12 systems across the world
including Europe and Korea and to develop others within the U.S."
From "The Army is Using Telepathology to Help with the Shortage of
Pathologists." Federal Telemedicine Update. February 4, 2003
http://www.federaltelemedicine.com/n020403.htm
==
Forensic Pathologists:
"There is a growing shortage of qualified forensic pathologists in the
US. The specialty was first recognized by the American Board of
Pathology in 1959, and the number of physicians entering the specialty
rose steadily until quite recently. It is currently the case, however,
that more forensic pathologists retire each year than are trained. And
while there is an overall decline in the number of hospital autopsies
performed in the US each year, the number of medicolegal autopsies
required continues to grow with the population."
From "Pathology Department: Training Opportunities." Wake forest
University Baptist Medical Center.
http://www.wfubmc.edu/pathology/training/forensic.htm
==
The nationwide shortage of forensic pathologists is also noted in the
following article:
"Forensic pathologists shortage may slow search for replacement, " by
William R. Leve. St. Petersburg Times. Jun 30, 2000
http://www.amosking.com/legal/forensic.htm
==
Pediatric Pathologist shortage noted:
"Mary Davis presented data from her survey, which focused on the
demographics, practice setting and activities of the membership. The
results highlight the present shortage of pediatric pathologists in
North America, which will become more serious in the next few years."
From "PRACTICE COMMITTEE." Gareth Jevon, Chair. The Newsletter.
Society for Pediatric Pathology. Spring 2004.
http://www.spponline.org/nwsltr/newsletter.htm
==
A series of links to articles highlighting the shortage of pathology
lab personnel can be found on the American Society for Clinical
Pathology website:
http://www.ascp.org/general/media/shortage.asp
==
Once again, I hope these references are helpful. If you need further
clarification, please don't hesitate to ask and I will help if I can.
Sincerely,
umiat
Search Strategy (on numerous search engines and databases)
projected shortage of nephrologists
number of Nephrologists in United States
shortage and projections AND neonatologists
projectsions AND neonatologists
shortage of neonatologists
need for neonatologists
pathologist shortage +U.S.
pathologists
medical pathologists outlook
the need for pathologists AND U.S.
is there a shortage of pathologists?
projections AND hospitalists
need for hospitalists
the need for hospitalists AND U.S.
job projections AND pulmonologists
shortage of pulmonologists
shortage of Oncologists +U.S.
shortage of cancer physicians
shortage of specialty physicians |
