Major Shortage of Endocrinologists in the United
States
The number of endocrinologists being trained is insufficient
to maintain access to endocrinologist services at
current levels, 12% lower than demand.
The objective of this study was to define the workforce
needs for the specialty of Endocrinology, Diabetes,
and Metabolism in the United States between 1999
and 2020.
An interactive model of factors likely to influence
the balance between the supply and demand of endocrinologists
during the next 20 years was constructed. The model
used data from a wide range of sources and was developed
under the guidance of a panel of experts derived
from sponsoring organizations of endocrinologists.
We determined current and projected numbers and demographics
of endocrinologists in the U.S. workforce and the
anticipated balance between supply and demand from
1999 to 2020.
There were 3,623 adult endocrinologists in the workforce
in 1999, of which 2,389 (66%) were in office-based
practice. Their median age was 49 years. Both total
office visits and services performed by endocrinologists
(particularly for diabetes) increased substantially
during the 1990s. Waiting time for an initial appointment
is presently longer for endocrinologists than for
other physicians. Compared with a balanced, largely
closed-staff health maintenance organization, the
current national supply of endocrinologists is estimated
to be 12% lower than demand.
The number of endocrinologists entering the market
has continuously fallen over the previous 5 years,
from 200 in 1995 to 171 in 1999. Even if this downward
trend were abruptly stopped, the model predicts that
demand will exceed supply from now until 2020. While
this gap narrows from 2000 to 2008 due to projected
growth of managed care, it widens thereafter due
to the aging of both the population and the endocrine
workforce. Inclusion of other factors such as projected
real income growth and increased prevalence of age-related
endocrine disorders (e.g., diabetes and osteoporosis)
further accentuates the deficit. If the number of
endocrinologists entering the workforce remains at
1999 levels, demand will continue to exceed supply
from now through 2020 for adult endocrinologists,
and the gap will widen progressively from 2010 onward.
The present analysis indicates that the number of
endocrinologists entering the workforce will not
be sufficient to meet future demand. These data suggest
that steps should be taken to stop the ongoing decline
in the number of endocrinologists in training and
consideration should be given to actions designed
to increase the number of endocrinologists in practice
in the years ahead. The care of patients with diabetes
by non-endocrinologists may become more successful
as the result of education, technology, and improved
pharmacotherapy, which make it easier to care for
these patients and thus lessen the demand for endocrinologists.
Diabetes Care 2003 May;26(5):1545-1552
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