Pathologist Workforce in the United States I. Development of a Predictive Model to Examine Factors Influencing Supply
Pathologist Workforce in the United States I. Development of a Predictive Model to Examine Factors Influencing Supply
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DOI：
10.5858/arpa.2013-0200-oa
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发表时间：
2013-12-01
影响因子：
4.6
通讯作者：
Black-Schaffer, W. Stephen
中科院分区：
文献类型：
--
作者：
Robboy, Stanley J.;Weintraub, Sally;Black-Schaffer, W. Stephen
背景。-先前病理学劳动力调查的结果在平衡状态和短缺预测之间变化。评估病理学家的当前和未来供应，并应用动态建模工具来评估不断变化的市场力量和新兴技术对病理学家服务供应的影响，直到2030年。数据来自各种来源，包括文献，美国病理学家学院的内部数据，以及通过为会员和病理实践管理人员定制的调查进行的主要研究结果。截至2010年，美国约有18000名积极执业的病理学家（每10万人口中有5.7名），其中约93%获得了委员会认证。我们的模型预测，在未来20年内，执业病理学家的绝对人数和人均人数将减少到约14 000名全职病理学家或每10万人中有3.7名。这一预测表明，从2015年开始，退休的病理学家人数将急剧增加，预计到2021年将达到峰值。包括所有类型的离职，病理学家的净人数到2015年将开始下降。除非劳动力进入或退出率发生变化，否则这一趋势将至少持续到2030年。这些变化反映了许多培训项目的关闭2至40年前和毕业生的数量大幅减少。这项综合分析预测，病理学家的人数将从2015年开始稳步下降。预计人口增长一般和疾病发病率的增加，由于人口老龄化，将在一个配套文章中提出的要求，将导致净赤字超过5700全职病理学家。为了达到到2030年病理学家数量近20 000名FTE的预期需求，将需要从今天增加约8.1%的住院医师职位。我们认为，病理学家短缺将对患者获得实验室服务和医疗保健提供者为患者群体提供更有效医疗保健的能力产生负面影响。
Context.-Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage.Objective.-To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of changing market forces and emerging technologies on the supply of pathologists' services through 2030.Design.-Data came from various sources, including the literature, College of American Pathologists' internal data, and primary research through custom-developed surveys for the membership and for pathology practice managersResults.-Through 2010, there were approximately 18 000 actively practicing pathologists in the United States (5.7 per 100 000 population), approximately 93% of whom were board certified. Our model projects that the absolute and per capita numbers of practicing pathologists will decrease to approximately 14 000 full-time equivalent (FTE) pathologists or 3.7 per 100 000 in the coming 2 decades. This projection reflects that beginning in 2015, the numbers of pathologists retiring will increase precipitously, and is anticipated to peak by 2021. Including all types of separation, the net pathologist strength will begin falling by year 2015. Unless workforce entry or exit rates change, this trend will continue at least through 2030. These changes reflect the closure of many training programs 2 to 4 decades ago and the substantially decreased number of graduating residents.Conclusions.-This comprehensive analysis predicts that pathologist numbers will decline steadily beginning in 2015. Anticipated population growth in general and increases in disease incidence owing to the aging population, to be presented in a companion article on demand, will lead to a net deficit in excess of more than 5700 FTE pathologists. To reach the projected need in pathologist numbers of nearly 20 000 FTE by 2030 will require an increase from today of approximately 8.1% more residency positions. We believe a pathologist shortage will negatively impact both patient access to laboratory services and health care providers' abilities to deliver more effective health care to their patient populations.