Estimate of Current Hospice and Palliative Medicine Physician Workforce Shortage
Estimate of Current Hospice and Palliative Medicine Physician Workforce Shortage
复制标题
DOI：
10.1016/j.jpainsymman.2010.07.004
复制
发表时间：
2010-12-01
影响因子：
4.7
通讯作者：
Lupu, Dale
中科院分区：
文献类型：
--
作者：
Lupu, Dale
上下文在建立一个新的医学专业的背景下，临终关怀和姑息治疗计划的快速增长，以及许多关于长期拖延填补临终关怀和姑息医学（HPM）医生空缺职位的轶事报道，美国临终关怀与姑息医学学会（AAHPM）在2008年任命了一个劳动力工作组，以评估是否存在医生短缺，并制定一个估计的最佳数量的HPM医生的需要。评估HPM医生的当前供应和当前需求。确定是否存在短缺，并估计短缺的规模在全职当量（FTE）和个别医生需要。该工作组预测了国家对临终关怀和医院姑息治疗医生的需求，通过对选定的示范机构的医生使用模式进行假设性的国家需求建模。该模型是基于假设，所有的临终关怀和医院将提供适当的医疗人员配备水平，这可能不是目前的情况。目前大约有4400名医生是HPM医生，由AAHPM的董事会认证或成员资格定义。大多数实践HPM兼职，导致估计的医生劳动力水平从1700 FTE到3300 FTE。据估计，需要4487个临终关怀和10,810个姑息治疗医生全职工作人员，以适当水平的临终关怀和医院为基础的姑息治疗计划的现有数量。因此，估计目前的供应和假设的需求之间的差距，以达到成熟的医生的人员配备水平是2787 FTE到7510 FTE，这相当于6000- 18000个医生，这取决于每个医生的时间比例致力于HPM的做法。HPM医生严重短缺。研究金方案目前的能力不足以填补短缺。需要改变研究生医学教育的资金和结构，以培养培养足够数量的HPM医生的能力。疼痛症状管理杂志2010;40：899-911。(C)2010年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. In the context of the establishment of a new medical specialty, rapid growth in hospices and palliative care programs, and many anecdotal reports about long delays in filling open positions for hospice and palliative medicine (HPM) physicians, the American Academy of Hospice and Palliative Medicine (AAHPM) appointed a Workforce Task Force in 2008 to assess whether a physician shortage existed and to develop an estimate of the optimal number of HPM physicians needed.Objectives. Develop estimates of the current supply and current need for HPM physicians. Determine whether a shortage exists and estimate size of shortage in full-time equivalents (FTEs) and individual physicians needed.Methods. The Task Force projected national demand for physicians in hospice-and in hospital-based palliative care by modeling hypothetical national demand on the observed pattern of physician use at selected exemplar institutions. The model was based on assumptions that all hospices and hospitals would provide an appropriate medical staffing level, which may not currently be the case.Results. Approximately 4400 physicians are currently HPM physicians, as defined by board certification or membership in the AAHPM. Most practice HPM part time, leading to an estimated physician workforce level from 1700 FTEs to 3300 FTEs. An estimated 4487 hospice and 10,810 palliative care physician FTEs are needed to staff the current number of hospice-and hospital-based palliative care programs at appropriate levels. The estimated gap between the current supply and the hypothetical demand to reach mature physician staffing levels is thus 2787 FTEs to 7510 FTEs, which is equivalent to 6000-18,000 individual physicians, depending on what proportion of time each physician devotes to HPM practice.Conclusion. An acute shortage of HPM physicians exists. The current capacity of fellowship programs is insufficient to fill the shortage. Changes in graduate medical education funding and structures are needed to foster the capacity to train sufficient numbers of HPM physicians. J Pain Symptom Manage 2010;40:899-911. (C) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.