The General Pediatrician: Projecting Future Workforce Supply and Requirements
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* Departments of Pediatrics and Public Health, Oregon Health and Science University, Portland, Oregon
Departments of Internal Medicine
Community and Family Medicine
¶ Pediatrics
|| Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire
Objective. Trends affecting both the supply and requirements of child health physicians call into question earlier assessments about the adequacy of the general pediatric workforce. To understand the effects of these trends over time, we developed a model that projects the national supply of practicing general pediatricians over a 20-year period (2000–2020).
Design. The model incorporates current data on the practicing pediatrician workforce in the United States, pediatric residency graduates entering general pediatrics, and gender- and age-specific measures of productivity and of retirement or death. In addition, it accounts for projected changes in the size and ethnicity of the child population and the proportion of children currently receiving outpatient care from family practitioners.
Main Outcome Measures. Time trend of the supply of general pediatricians and the number of children in the population per practicing pediatrician.
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.
Key Words: workforce • child/children • primary care • access • graduate medical education
Abbreviations: AAP, American Academy of Pediatrics • GME, graduate medical education • AMA, American Medical Association • AOA, American Osteopathic Association • IMG, international medical graduate • FTE, full-time equivalent • NAMCS, National Ambulatory Medical Care Survey
Received for publication Jul 21, 2003; Accepted Oct 31, 2003.
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