Hello, cwbrd!
This batch of physician specialties was quite hard but I can't give
you any reason why other than to blame the overall lack of
comprehensive information that exists for this entire field of
research. I often run across numerous articles that highlight
shortages or predictions within a particular state or region, but
often nothing pertaining to the country as a whole. Or, several
specialties will be grouped together with very general information
about shortages, but nothing that can be quantified or broken down by
specific medical field. Since I don't want to return an answer with
sections that say "nothing much found", I just keep going until I feel
I have exhausted the resources.
I have compiled the most useful articles for this specific group of
specialties. I am hoping that the substitution of gastroenterologist
for "gastrointestinal physician" is acceptable, since the literature
continually seemed to substitute that term.
On another note.....yes - I am happy to continue on with this line of
research. As long as I know that your deadline is not extremely tight,
and we mutually agree that information might be very sparse for some
specialties, I will be happy to find all that I can for you on any
future questions you may wish to direct my way. Thank you for
continuing to consider me!
***********
UROLOGISTS
***********
"In a recent study of medical school deans and state medical society
executives, urology was identified as one of many specialties believed
to be in short supply."
"Drawing an accurate picture of urologist supply and demand will be
challenging, as several urologists investigating the issue have found.
Dennis Venable, MD, chairman of the department of urology at Louisiana
State University Health Sciences Center, Shreveport, attempted to find
out how many urologists were practicing in the United States while
preparing a report to the Florida State Urological Society last year.
"I contacted five different organizations or groups and got five
different numbers, ranging from 6,000 to more than 10,000," he said.
"The AUA currently feels the number is around 8,800, but in reality no
one knows for certain because 'urologist' is a nebulous term in the
sense that many doctors practice urology who are not board certified.
These would be some general surgeons, pediatric surgeons, and some
physicians who have trained here or abroad but never received
accreditation."
"David McCullough, MD, has been following urology workforce
requirements for a number of years. In an article in Contemporary
Urology (May 2003, pages 18-27), Dr. McCullough cited data showing
that between the 1990s and 2000, the number of urologic residents
dropped by 6.5%, the number of postgraduate year 1 residents dropped
by 11%, and the number of chief residents fell by 5%.
"A subtly dwindling supply is but one of a number of familiar factors
exacerbating the shortage. According to data from Merritt, Hawkins &
Associates, 38% of practicing urologists are aged 55 years or older,
and factors such as increasing workloads, soaring medical liability
insurance rates, and continuing hassles with the government and
managed care organizations are making retirement look increasingly
attractive."
(Read entire article)
Read "Urologists, others say it may be too little, too late to stem
the tide of dwindling numbers," by Mac Overmyer. Urology Times. Feb.
1, 2003.
http://ut.adv100.com/urologytimes/article/articleDetail.jsp?id=82972
==
"Many communities are desperate for urologic care. Numerous towns in
the southeast, which once had several practicing urologists, now have
a single urologist over age 55 or none at all. Recruitment to these
towns has been fruitless for as long as a decade, and the future
offers little or no hope for improvement. Because of the difficulty in
recruiting young urologists, some small groups in rural areas survive
by using locum tenens assistance to cover for continuing medical
education and vacations."
"In the future, urologists will be less likely to follow patients
long-term and, instead, will return many to family practice for
follow-up. As the population of aging patients grows, and with it the
need for services now in the realm of urology, there is a distinct
possibility that many of these procedures will be appropriated by
other physicians currently performing similar functions. This trend is
already evident, with gynecologists caring for incontinent women,
family practitioners treating erectile dysfunction, general surgeons
performing laparoscopic nephrectomy, and pediatric surgeons managing
pediatric urology cases."
From "Dr. shortage: Dx made. Tx needed - stat!" Editorial.
Contemporary Urology Archive. August 2004.
http://www.jaapa.com/be_core/content/journals/u/data/2004/0801/editaug2004.html
==
The following article predicts a "35% increase in urologic surgeries by 2020":
"Urologists remain high on the list of in-demand medical specialists
in the United States, and their services are even more sought-after
than in previous years, according to recently released research. To
attract them, hospitals and practices are offering more enticing
salaries and other incentives."
Asked to characterize the current state of urology, Schnapp of
Merritt, Hawkins painted a picture of a specialty in flux. A number of
urologists, like other specialists, have been driven from their
profession or have been forced to relocate during the past 5 years by
a combination of rising medical liability insurance rates and the
headaches associated with managed care and third-party payers. But
many of these physicians appear to have changed their minds, Schnapp
said."
"What I have noticed from responses to our recruiting activities among
urologists is that a fair number of these physicians are 55 and older.
They may have stopped practicing for a while or were semi-retired," he
told Urology Times. "They may have lost some of their retirement money
in the stock market or are not happy with retirement. A lot have
decided to get back in on a semi- or full-time basis."
"While offers appear to be great for urology residents entering the
workforce and practicing urologists willing to relocate, the data
suggest a piece of bad news as well. Heightened demand for certain
specialists, including urologists, tends to indicate that there is a
national shortage of these physicians. Simply looking at the average
age of practicing urologists shows that more than one-third are within
a decade of retiring."
"The information I'm looking at right now is that 38% of urologists
are 55 or older," Schnapp said. "AUA's own data support this number,
with 40% of the association's members in the 55-year-and-older age
range."
"The nation is aging along with its urologists, fueling demand for
urologic services. David A. Etzioni, MD, a clinical scholar at the
UCLA School of Medicine, suggests that the procedure-based work in
urology will increase by 35% by the year 2020, due to the aging of the
baby boomers (Ann Surg 2003; 238:170-7)."
From "Demand for urologists, incentives to relocate soaring," by Mac
Overmyer. Urology Times. Sept. 1, 2003.
http://www.urologytimes.com/urologytimes/article/articleDetail.jsp?id=68850
==
There are growing indications that the United States faces a serious
shortage of specialist physicians. Those in shortest supply:
anesthesiologists, gerontologists, cardiologists, pulmonologists,
** urologists,
oncologists, gastroenterologists, hematologists, and intensive care physicians.
Source: American Medical News - Jan. 22, 2001
http://www.ama-assn.org/sci-pubs/amnews/pick_01/prsa0122.htm
**************
HEMATOLOGISTS
**************
There is a lack of hard numbers and projections for hematologists as a
singular practice. The practice of hematology appears to be merging
with oncology, creating a dilution in the hematology arena. The only
information I have found pertaining to the outlook for this specialty
predicts that numbers of practicing physicians are static or
declining.
==
"The field of hematology is growing increasingly complex, especially
in the area of hemostatic and thrombotic disorders. Paradoxically,
however, the number of practicing clinical hematologists in the United
States has been static or has even decreased. Many physicians who
practice hematology, both those in the community and those in
academia, are combining their practice with that of medical oncology,
thereby diluting their clinical experience.."
From Book Review of "Consultative Hemostasis and Thrombosis." New
England Journal of Medicine. Volume 348:1072-1073 March 13, 2003
http://content.nejm.org/cgi/content/extract/348/11/1072
==
A 2002 message from the President of the American Society of
Hematology goes into great detail about the dilution of the field of
Hematology.
Excerpts:
"While the American Society of Hematology, which represents a broad
alliance of physicians and scientists interested in the blood and
blood disorders, continues to thrive, its physician members, who
practice the discipline of hematology, struggle as their clinical
territory and mandate is continuously "redefined."
"My concern is that very few, if any, practitioners outside of major
academic centers are able to devote themselves exclusively to even a
subset of hematologic disorders. In many cases they find themselves
battling with oncologists or other providers over patients of common
interest. To pay the bills they either extend their practice beyond
hematology and care for a broader group of patients with malignancy,
i.e., they become hematologist-oncologists, or they become part-time
primary care internists."
"As a result, the practice of hematology looks less appealing and the
number of young physicians who elect to train solely in hematology
continues to decline. Training in medical oncology alone, or training
in hematology-oncology are clearly the more popular alternatives.
While almost every physician who completes training in a combined
hematology-oncology program will eventually take the oncology boards,
only a fraction (about 50%) will pay the extra money and commit the
extra time needed to also become certified in hematology."
"As previously noted, practice opportunities for hematologists that
are truly independent of oncology are dwindling and the identity of
the medical specialty of hematology could eventually be jeopardized.
It has been disturbing to me to learn many HMOs and third party payers
do not currently recognize hematology as a distinct clinical
discipline. Also, it is disappointing that the magazines, such as U.S.
News and World Report, that rate hospitals on a composite of their
excellence in various clinical areas do not evaluate hematologists.
Similarly, when I examined the "Best Doctor" lists in several
magazines that promote individual cities (Boston, New York, Washington
D.C., etc.), I noted that oncologists are listed, along with many
other medical sub-specialists, but hematologists are not."
"The revolution in cancer care and the increased complexity of therapy
for all blood diseases has made it crystal clear that, to be
competitive, hematologists have to specialize. In fact, we are an
eclectic confederation of sub-sub-specialists united by our
fascination by the blood and its disorders."
"There are various ways that the hematology-oncology "battle" has been
resolved. For example, many physicians with an interest in hematologic
malignancy are now members of combined hematology-oncology divisions
or work in Comprehensive Cancer Centers, where they can easily treat
malignant hematologic disorders like leukemia or lymphoma. Since their
work is clearly aligned with the cancer center's mission they are
fully integrated and become indistinguishable from medical oncologists
who specialize in hematologic malignancy."
Read further...
From "Whither the Practice of Hematology? Or Should it be Wither?," by
Robert I. Handin, M.D., 2002 ASH President.
http://www.hematology.org/news/spring02/index.cfm?news=art03
==
A further recognition of the shortage of hematologists:
"The Senate version of the Labor/HHS/Education appropriations bill is
awaiting action by the full Senate. The accompanying report language
(Sen. Rpt. 107-216) mentions several activities related to the mission
of the NHLBI. For example, the committee urges the NHLBI to
*** expand efforts to reduce the shortage of hematologists ***."
From "News from Capitol Hill." NHLBI. December 2002. Volume 3, Issue 3.
http://www.nhlbi.nih.gov/public/dec02/newsitms.htm
==
From an article I cited in one of your previous answers:
"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."
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
==
"There are growing indications that the United States faces a serious
shortage of specialist physicians. Those in shortest supply:
anesthesiologists, gerontologists, cardiologists, pulmonologists,
urologists, oncologists, gastroenterologists,
** hematologists,
and intensive care physicians.
Source: American Medical News - Jan. 22, 2001
http://www.ama-assn.org/sci-pubs/amnews/pick_01/prsa0122.htm
**************************************
GASTROENTEROLOGISTS (GI specialists)
**************************************
"The United States is presently experiencing a relative shortage of
trained gastroenterologists, one that was not predicted as recently as
a decade ago. In fact, in 1996 the Gastroenterology Leadership
Council, after performing a workforce modeling study that anticipated
an oversupply of gastroenterologists, recommended that the number of
training positions be decreased by 25%-50%. Unfortunately, that
decreased supply has bumped up against an increased demand in recent
years."
From "The Case - Bowel Prep."
http://www.webmm.ahrq.gov/cases.aspx?ic=67
==
The national shortage of gatroenterologists is also mentioned in the
following article dealing with performing more routine colonoscopies.
"Joseph Selby, M.D., director of the research division at Kaiser
Permanente Health Plans, questioned the relative safety of colonoscopy
if it is diffused into community practice."You have to remember that
in the [July 20 NEJM study led by David A. Lieberman, M.D.],
colonoscopy was performed by very senior people, in a high-throughput
screening mode," said Selby. "With newer, less-experienced examiners
trying to work faster with the price cut in half, I doubt you will see
the same results."
Questions of feasibility also concern many observers. "We can?t really
do it because we don?t have the people to do it," Selby said. "There
is a national shortage of gastroenterologists. If you wanted to do it,
you would use up all your gastroenterologists, and there would be no
time left to deal with bowel obstructions, upper endoscopies, and
liver disease."
From "Cost-Effectiveness Studies Fan Colonoscopy Debate," by Laura
Newman. Journal of the National Cancer Institute, Vol. 92, No. 22,
1796-1798,
November 15, 2000
http://jncicancerspectrum.oupjournals.org/cgi/content/full/jnci;92/22/1796
==
There are growing indications that the United States faces a serious
shortage of specialist physicians. Those in shortest supply:
anesthesiologists, gerontologists, cardiologists, pulmonologists,
urologists, oncologists,
** gastroenterologists,
hematologists, and intensive care physicians.
Source: American Medical News - Jan. 22, 2001
http://www.ama-assn.org/sci-pubs/amnews/pick_01/prsa0122.htm
Some good history about the declines and present rise in choosing
gastroenterology as a specialty can be found in the following power
point presentation:
"How to Attract the Best and the Brightest?," by Rodger A. Liddle,
M.D. March 22, 2003
http://66.102.7.104/search?q=cache:6PN3E-ORVsIJ:www.gastro.org/gi-training/presentations/8%2520Dr.%2520Liddle%2520presentation.ppt+US+shortage+of+gastroenterologists&hl=en
**************************
OBSTETRICIAN/GYNECOLOGISTS
**************************
According to 2002 figures from the AMA:
Obstetrician/Gynecologists account for 5.4% of the estimated number of
physicians in direct patient care in the U.S.
From "Facts About Family Medicine."
http://www.futurefamilymed.org/PreBuilt/FactsAboutFamilyMed.pdf
==
Number of Physicians by Specialty per 100,000 People (Urban vs. Rural)
OB/GYN Specialists
Urban - 13.7 per 100,000
Rural - 5.1 per 100,000
From "Access to quality health services in rural areas - primary care:
a Literature review, "by Larry Gamm, Graciela Castillo, and Stephanie
Pittman.
http://www.srph.tamushsc.edu/rhp2010/litreview/Vol2accessprimarycare.htm
==
A likely future trend away from obstetrics:
"Minkin, 52, plans to set aside her scalpel this winter before her
malpractice insurance premiums go up again. "Like many other
obstetrician/gynecologists, Minkin plans to limit her practice to
gynecology, a field where she will pay far lower premiums and is less
likely to be sued."
"Obstetricians nationwide, even those with the most experience, are
looking for the nearest exit sign from the delivery ward. One of every
seven fellows of the American College of Obstetricians and
Gynecologists has stopped delivering babies, according to a recent
survey."
"As a result of the exodus, other doctors will have to work longer
hours to deliver more babies, women will have to travel longer to find
an obstetrician, and some mothers-to-be may settle for a midwife and
hope there are no complications, said Tim Norbeck, executive director
of the Connecticut State Medical Society in New Haven."
"I see this as a dangerous path. This will mean a lot fewer doctors
doing a lot more deliveries. We?re going to see a huge increase in
infant mortality. We?re going to see more dead moms," Minkin said.
"Ten years ago we thought there was going to be a surplus of OB-GYNs.
Now we think there will be a shortage," Lockwood said."
* "Obstetrics residents - the next generation of OB-GYNs - can?t even
fill the number of available slots at hospitals nationally. The number
of slots filled dropped from 86 percent in 1994 to 65 percent in 2004,
according to the American College of Obstetricians and Gynecologists."
"Although obstetrics has a reputation as one of the most physically
demanding fields, given its irregular hours and late-night deliveries,
women have flocked to the practice: Roughly 80 percent of all U.S.
obstetrics residents are women.
From "Noted OB-GYN can't afford to stay in business," by Maria
Garriga. New Haven Register. June 8, 2004.
http://www.nhregister.com/site/news.cfm?newsid=12644481&BRD=1281&PAG=461
==
Fewer medical students choosing OB/GYN as a specialty:
"There have been exciting changes in our specialty during the last 10
years: advances in basic science, in clinical practice, and in the
social dynamics of health care for women. But there are three
challenges that represent serious problems: 1) the recruitment of
medical students, 2) changes in our residency programs, and 3) the new
face of private or academic practice."
"The first of these challenges is the recruitment of medical students.
In 1998, 93% of our residency positions were filled with graduates of
US medical schools. Three years later, that number had fallen to 82%.
In 1993, 982 US seniors matched into our residencies; this year, the
number was 786.1,2 The average percentage of graduating US seniors
choosing a career in obstetrics and gynecology peaked in 1993 at
7.5%.1 That percentage has now dropped to 5.9%.2 There are reasons for
this disturbing trend. Young physicians today seem to value lifestyle
above other factors in their selection of a specialty. The popular
choices are emergency medicine, radiology, ophthalmology,
anesthesiology, and dermatology. Within the specialty of obstetrics
and gynecology, we have not done an adequate job of preparing
graduating students for our programs."
From "Springtime for Obstetrics and Gynecology: Will the Specialty
Continue to Blossom? John M. Gibbons, Jr, MD, President, ACOG."
Obstetrics & Gynecology 2003;102:443-445
http://www.greenjournal.org/cgi/content/full/102/3/443?ijkey=7e1ee210de6dd382405f6c484b9e68d512a96eaf&keytype2=tf_ipsecsha
==
"The results of the 2003 National Resident Matching Program showed
fewer US medical student seniors entering the field of obstetrics and
gynecology than in the past. The number of postgraduate year 1
positions has remained remarkably stable over the last decade, at
around 1150 positions. This year, only 68% of available obstetrics and
gynecology residency positions were filled by US medical school
seniors, compared with 86% a decade ago. The number of foreign medical
graduates filling these positions is increasing. The trend of fewer US
senior students choosing to specialize in obstetrics and gynecology
has very serious implications, the most obvious of which is the
potential for physician shortages. Second, the dwindling popularity of
the specialty can influence medical students against considering
obstetrics and gynecology as a viable career choice. These factors
urgently deserve our attention because they seriously jeopardize
future health care delivery for women."
"Is dissatisfaction in the field of obstetrics and gynecology real or
anecdotal? In their article in this month?s issue,1 Kravitz et al
present the result of a survey showing that 25% were dissatisfied with
their career choice. These were predominantly younger physicians.
Obstetrician-gynecologists were significantly less satisfied than
primary care physicians. They also were dissatisfied with the
opportunity for continuity of care. The sampling of physicians is
already several years old, and I suggest that the dissatisfaction has
increased since then."
From "The Future of Obstetrics and Gynecology," by John T. Queenan,
MD, Deputy Editor. Obstetrics & Gynecology 2003;102:441-442
http://www.greenjournal.org/cgi/content/full/102/3/441?ijkey=520b3a3c742bed0291358b4ee86924e52435f01d&keytype2=tf_ipsecsha
******************
INTERNAL MEDICINE
******************
According to 2002 figures from the AMA:
Internal Medicine physicians account for 13.5% of the estimated number
of physicians in direct patient care in the U.S.
From "Facts About Family Medicine."
http://www.futurefamilymed.org/PreBuilt/FactsAboutFamilyMed.pdf
==
Number of Physicians by Specialty per 100,000 People (Urban vs. Rural)
General Internists
Urban - 35.4 per 100,000
Rural - 11.8 per 100,000
From "Access to quality health services in rural areas - primary care:
a Literature review, "by Larry Gamm, Graciela Castillo, and Stephanie
Pittman.
http://www.srph.tamushsc.edu/rhp2010/litreview/Vol2accessprimarycare.htm
==
Two somewhat conflicting messages follow concerning the continued
choice to follow a career in internal medicine:
"Despite beliefs that internal medicine is attracting a decreasing
number of physicians, the overall numbers of physicians that
eventually enter internal medicine training will remain stable over
the next decade; however, the numbers of physicians entering internal
medicine through specific training pathways will vary. The overall
number of physicians matching into categorical residencies will remain
stable. About one in six U.S. medical graduates are expected to match
(National Residency Matching Program, NRMP) into categorical
residencies (U.S. Seniors, PGY1) and continue to make up about
one-third (33%-35%) of the internal medicine residents."
* "As a result of these competing trends, internal medicine will
continue to account for 20-25% of physicians practicing medicine."
Chart 4 - "Table 5.2: Physicians by specialty from 1975 through 2002:
(see link) shows that 185,926 physicians were practicing internal
medicine (along with subspecialties) in the US in 2002.
From "Internists in the Physician Workforce." Environmental
Assessment. ACP Research Center. May 14, 2004
http://ea.acponline.org/physicians/IPW.html
==
"Internal medicine has become less appealing as a career choice for US
medical school graduates (USMGs). In 2004, 1,015 fewer graduates
selected categorical residency programs in internal medicine than in
1978. Interest in internal medicine has dropped, although the number
of students at US medical schools has increased 7.7 percent, from
62,213 in 1978 to 67,013 in 2003. Fewer students are selecting
internal medicine because they have more professional choices than
ever before, face greater debt, recognize that internists
(particularly general internal medicine) have lower salaries than
other disciplines, seek controllable lifestyles, sense that internists
in practice are unhappy, and consider internal medicine the field of
chronic disease and geriatrics (care that the current system does not
value)."
From "Results of AAIM Retreat for Executive Directors of Societies
that Represent Internists, "Core Learning and Beyond: Redesigning
Education in Internal Medicine." Alliance for Academic Internal
Medicine. September 16, 2004
http://www.im.org/AAIM/Meetings/Docs/execdir/edsept2004.htm
==
"In the 2003 graduating classes of U.S. medical schools, of 14,332
matched graduates, only 47 seniors opted for residency training in
primary care pediatrics,
** 192 matched into primary care internal medicine,
and 258 matched into combined internal medicine and pediatric
residencies. The number of U.S. graduates entering family medicine
dropped to 1,234, barely one half of 1997 numbers. Most graduating
medical doctors opted for more specialized fields or for programs in
internal medicine or pediatrics that provide the opportunity to
subspecialize."
From "The U.S. Primary Care Physician Workforce: Persistently
Declining Interest in Primary Care Medical Specialties." The Robert
Graham Center. October 2003, Number 23.
http://www.graham-center.org/x468.xml
**************
PEDIATRICIANS
**************
According to 2002 figures from the AMA:
Pediatricians account for 7.2% of the estimated number of physicians
in direct patient care in the U.S.
From "Facts About Family Medicine."
http://www.futurefamilymed.org/PreBuilt/FactsAboutFamilyMed.pdf
==
Number of Physicians by Specialty per 100,000 People (Urban vs. Rural)
Pediatricians
Urban - 17.5 per 100,000
Rural - 5.2 per 100,000
From "Access to quality health services in rural areas - primary care:
a Literature review, "by Larry Gamm, Graciela Castillo, and Stephanie
Pittman.
http://www.srph.tamushsc.edu/rhp2010/litreview/Vol2accessprimarycare.htm
==
"During the next 20 years there will be a 58 percent increase in the
number of pediatricians and only a 9.3 percent increase in the number
of children in the United States, according to a study led by an
Oregon Health & Science University pediatrics researcher. The study is
one of the first published that looks specifically at the number of
physicians who specialize in caring for children and uses a
statistical model to assess outside forces that could impact the work
force. The study, "The Expanding General Pediatrician Workforce," will
be published in the March issue of the journal..."
"The American Academy of Pediatrics concluded in 1998 that the total
supply of pediatricians in the nation was adequate to meet the needs
of the population. Today, there is approximately one pediatrician for
every 2,040 children in the U.S. population. By 2020 this model
predicts there will be one pediatrician for every 1,400 children.
Shipman's study found that the experience in pediatrics differs
greatly from other primary care specialties, including family medicine
and internal medicine, which are projected to begin a decline during
the next 20 years relative to the growth in the populations they
serve. According to researchers, the expanding elderly population is
the driving force behind this disparity."
"Even education appears not to have much of impact. The study found
that even if there were a 50 percent decrease in students entering
pediatrics training or pediatric residents selecting careers in
general pediatrics; the pediatrician work force could nearly maintain
its current size relative to the child population for the next 20
years."
"STUDY SHOWS UNITED STATES MAY HAVE MORE PEDIATRICIANS THAN IT NEEDS
FOR THE NEXT 20 YEARS." OHSU News and Information. March 1, 2004
http://www.ohsu.edu/news/2004/030104peds.html
==
See the abstract for the above-mentioned study:
Results - "The baseline model projects that the number of general
pediatricians will expand by nearly 25 000 by the year 2020, a 64%
increase from the year 2000, whereas the child population is projected
to expand by only 9%. The increase was robust to sensitivity analyses
measuring the impact of each of the model?s variables on the future
supply of pediatricians. In all probable scenarios, the general
pediatrician workforce will expand significantly more rapidly than the
child population. In addition, the trend in pediatrics is in marked
contrast to the other primary care specialties."
Conclusions - "Despite a number of factors that might attenuate the
growth of the general pediatrician workforce, none seems sufficient to
slow its expansion in relation to the pediatric population. To
maintain practice volumes comparable to today, pediatricians of the
future may need to provide expanded services to the children currently
under their care, expand their patient population to include young
adults, and/or compete for a greater share of children currently cared
for by nonpediatricians."
From "The General Pediatrician: Projecting Future Workforce Supply and
Requirements." Scott A. Shipman, MD, MPH*, Jon D. Lurie, MD, MS,,||
and David C. Goodman, MD, MS. PEDIATRICS Vol. 113 No. 3 March 2004,
pp. 435-442
http://pediatrics.aappublications.org/cgi/content/abstract/113/3/435
==
Also see:
"The number of pediatricians in the United States rose by 140 percent
between 1978 and 2000." News-Medical in Child Health News. July 4,
2004
http://www.news-medical.net/?id=3061
"The general pediatrician: projecting future workforce supply and requirements
Pediatrics, March, 2004 by Scott A. Shipman, Jon D. Lurie, David C. Goodman
http://www.findarticles.com/p/articles/mi_m0950/is_3_113/ai_114591502
**********************
RADIATION ONCOLOGISTS
**********************
There seems to be an oversupply of radiation oncologists in the
clinical setting but an undersupply in the academic setting.
==
1996 numbers:
"In summary, the ASTRO Committee on Human Resources believes that
there is ample evidence for the existence of an oversupply of
radiation oncologists in the United States at the present time. It
believes that this oversupply has already affected the specialty in a
variety of ways that are difficult to measure, for example, increased
competition, conflicts between radiation oncology groups, conflicts
between the private sector and academics, and increased costs, and
that it is beginning to have a significant effect on the job market.
This oversupply came about because of the rapid expansion in medical
school enrollment in the 1970s. This led to an increased number of
graduates available for enrollment into specialty residencies, one of
which was radiation oncology. The actual number of radiation oncology
residency positions offered has not changed significantly since 1972.
However, only about half of the residency positions were filled in the
early years. Since 1986, virtually all radiation oncology training
positions in the United States have been filled, and this has led to a
significantly greater number of radiation oncologists entering the
field than have left the field through death or retirement.
Preliminary data suggest that a shift to a managed care system would
result in decreased demand for radiation oncology services, and that
would increase the manpower problem for our specialty."
From "Manpower needs for radiation oncology: a preliminary report of
the ASTRO Human Resources Committee. American Society for Therapeutic
Radiology and Oncology." Hussey DH, Horton JL, Mendenhall NP,
Munzenrider JE, Rose CM, Sunshine JH. Int J Radiat Oncol Biol Phys.
1996 Jul 1;35(4):809-20.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8690651
==
More from the ASTRO report: (1996 numbers)
"There is considerable data to indicate that there is indeed a surplus
of radiation oncologists at the present time, and that this surplus
will increase over the next decade. Approximately 165 radiation
oncologists are entering practice each year, and only about 45
radiation oncologists are leaving the field through death or
retirement. Thus, there is a net gain of ~120 radiation oncologists
entering the workforce each year."
The information indicating that approximately 45 radiation oncologists
leave practice each year is based on the age distribution of actively
practicing radiation oncologists (3,4), the age distribution of
retired radiation oncologists (3,4), and U.S. mortality tables (5)
(Table 1). It assumes that radiation oncologists will retire at the
same age in coming years as they have in the past, so that the age
distribution of retired radiation oncologists will remain unchanged.
It also assumes that radiation oncologists will die at the same rate
as the general population and that half of those who die will have
also retired. The analysis indicates that 338 radiation oncologists
will retire over the next 10 years and 203 will die. Since it is
assumed that half of those who die will have already retired, there
would be a net loss of 440 radiation oncologists from the workforce
(338 + [203 2] = 440), or 44 radiation oncologists per year.
"Is There an Oversupply of Radiation Oncologists?
http://www.sroa.org/_onconews/Vol6No2/oversupply.html
See "Projections for the Future."
http://www.sroa.org/_onconews/Vol6No2/project.html
==
From a 1997 SCAROP survey on resident training:
RESULTS: "The responses to the survey show a serious shortage of
radiation oncologists in university settings, despite an apparent
surplus in private practice."
From "Report of the 1997 SCAROP survey on resident training. Society
of Chairmen of Academic Radiation Oncology Programs." Hussey DH,
Sagerman RH, Halberg F, Dubey A, Coleman CN. Acad Radiol. 2000
Mar;7(3):176-83.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10730813&dopt=Abstract
==
Conclusion: "An overwhelming majority of 1995 radiation oncology
graduates believed that the job market had deteriorated and that there
was an oversupply of radiation oncologists."
From "The employment status of 1995 graduates from radiation oncology
training programs in the United States." Flynn DF, Kresl JJ, Sheldon
JM. Int J Radiat Oncol Biol Phys. 1999 Mar 15;43(5):1075-81.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10192359
==
The following article has some figures for hiring or radiation
oncologists mixed in with some other radiologic specialties:
"The demand side of the job market for diagnostic radiologists and
radiation oncologists: hiring by physician groups in 1995." Bushee GR,
Sunshine JH, Chan WC, Shaffer KA. AJR Am J Roentgenol. 1996
Aug;167(2):303-9.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8686591
==
I hope this helps!
umiat
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