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A Model to Determine Workforce Needs for Endocrinologists in the United States Until 2020¹

Divisions of Endocrinology, Metabolism, Nutrition, and Internal Medicine (R.A.R., W.F.Y.), Mayo Clinic and Foundation, Rochester, Minnesota 55905; Endocrinology Service (R.A.V.), Walter Reed Army Medical Center, Washington, D.C. 20307; American Association of Clinical Endocrinologists (H.W.R.), Rockville, Maryland 20850; Division of Endocrinology and Metabolism (P.W.L.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Division of Endocrinology and Metabolism (M.I.S.), Albert Einstein College of Medicine, Bronx, New York 10467; Chief Scientific and Medical Officer (R.K.), American Diabetes Association, Alexandria, Virginia 22311; and The Lewin Group (P.F.H.), Falls Church, Virginia 22042

Address all correspondence and requests for reprints to: Robert A. Vigersky, M.D., Endocrinology Service (7D), Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Washington, D.C. 20307. E-mail: Robert.Vigersky{at}na.amedd.army.mil.

Abstract

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 yr 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 United States 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 yr. 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 yr, 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. Whereas 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.

Footnotes

This study was supported by major grants from The Endocrine Society, the American Association of Clinical Endocrinologists, and the American Diabetes Association. Additional funding was received from the Association of Program Directors in Endocrinology and Metabolism and the American Thyroid Association.

This assessment relates only to manpower needs in adult endocrinology. The Lawson Wilkins Pediatric Endocrine Society is conducting a separate review of manpower needs in pediatric endocrinology.

¹ Simultaneous Publication:This manuscript is being simultaneously published in the following journals: Journal of Clinical Endocrinology and Metabolism, Diabetes Care, Endocrine Practice. (©2003 by The Endocrine Society, the American Diabetes Association, and the American Association of Clinical Endocrinologists.)

The full report is available on The Endocrine Society home page at: www.endo-society.org.

Abbreviations: AMA, American Medical Association; BMAD, Medicare Part B Beneficiary Annual Claims Data; COGME, Council on Graduate Medical Education; HMO, Health Maintenance Organization; IMG, international medical school graduate; NAMCS, National Ambulatory Medical Care Survey.

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