Mark W Russo1, Oren K Fix2, Ayman A Koteish3,4, Katie Duggan5, Marcia Ditmyer6, Michael Fuchs7, Raymond T Chung8, Gautham Reddy9. 1. Carolinas Medical Center, Atrium Health, Charlotte, NC, USA. 2. Organ Transplant and Liver Center, Swedish Medical Center, Seattle, WA, USA. 3. Advent Health, Orlando, FL, USA. 4. The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. American Association for the Study of Liver Diseases, Alexandria, VA, USA. 6. Academy for Advancing Leadership, Atlanta, GA, USA. 7. Central Virginia VA Health Care System, Virginia Commonwealth University, Richmond, VA, USA. 8. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 9. University of Chicago, Chicago, IL, USA.
Abstract
BACKGROUND AND AIMS: Liver disease is prevalent in the United States, and as the population ages, an increasing number of patients are anticipated to present for care. The state of the current hepatology workforce and future demand for hepatology providers is not known. The aim of this study was to model future projections for hepatology workforce demand. APPROACH AND RESULTS: A workforce study of hepatology providers in the United States was completed using primary and secondary data sources. An integrated workforce framework model was used that combined socioeconomic factors that drive economic demand, epidemiological factors that drive need, and utilization rates of health care services. Supply and demand projections were calculated for adult and pediatric hepatology professionals. Sensitivity analyses were conducted to cover the feasible range of these assumptions. An electronic survey of American Association for the Study of Liver Diseases (AASLD) members whose practice included 50% or more hepatology was conducted. In 2018, the adult and pediatric workforce included 7,296 and 824 hepatology providers, respectively, composed of hepatologists, gastroenterologists, and advanced practice providers whose practice was ≥50% hepatology. The modeling analysis projects that in 2023, 2028, and 2033, there will be shortages of 10%, 23%, and 35% adult hepatology providers, respectively, and 19%, 20%, and 16% pediatric hepatology providers, respectively. In sensitivity analyses, a shortage of hepatology providers is predicted even under optimistic assumptions. Among the respondents to the survey, the median age was higher among gastroenterologists and general hepatologists compared with transplant hepatologists. The most common category treated by transplant hepatologists was general hepatology. CONCLUSIONS: There is an impending critical shortage of adult and pediatric hepatology providers. Strategies are needed to encourage clinicians to pursue hepatology, especially in areas outside of transplant centers.
BACKGROUND AND AIMS: Liver disease is prevalent in the United States, and as the population ages, an increasing number of patients are anticipated to present for care. The state of the current hepatology workforce and future demand for hepatology providers is not known. The aim of this study was to model future projections for hepatology workforce demand. APPROACH AND RESULTS: A workforce study of hepatology providers in the United States was completed using primary and secondary data sources. An integrated workforce framework model was used that combined socioeconomic factors that drive economic demand, epidemiological factors that drive need, and utilization rates of health care services. Supply and demand projections were calculated for adult and pediatric hepatology professionals. Sensitivity analyses were conducted to cover the feasible range of these assumptions. An electronic survey of American Association for the Study of Liver Diseases (AASLD) members whose practice included 50% or more hepatology was conducted. In 2018, the adult and pediatric workforce included 7,296 and 824 hepatology providers, respectively, composed of hepatologists, gastroenterologists, and advanced practice providers whose practice was ≥50% hepatology. The modeling analysis projects that in 2023, 2028, and 2033, there will be shortages of 10%, 23%, and 35% adult hepatology providers, respectively, and 19%, 20%, and 16% pediatric hepatology providers, respectively. In sensitivity analyses, a shortage of hepatology providers is predicted even under optimistic assumptions. Among the respondents to the survey, the median age was higher among gastroenterologists and general hepatologists compared with transplant hepatologists. The most common category treated by transplant hepatologists was general hepatology. CONCLUSIONS: There is an impending critical shortage of adult and pediatric hepatology providers. Strategies are needed to encourage clinicians to pursue hepatology, especially in areas outside of transplant centers.
Authors: Patricia P Bloom; Trisha S Pasricha; Karin L Andersson; Daniel S Pratt; Nikroo Hashemi; Irun Bhan; Kathleen Viveiros Journal: Dig Dis Sci Date: 2020-07-29 Impact factor: 3.199
Authors: Mark W Russo; Ryan Kwok; Marina Serper; Nneka Ufere; Bilal Hameed; Jaime Chu; Elizabeth Goacher; John Lingerfelt; Norah Terrault; K Rajender Reddy Journal: Hepatol Commun Date: 2021-12-28
Authors: Adam E Mikolajczyk; Netanel Zilberstein; John F McConville; Alex Pan; Andrew I Aronsohn; Helen S Te; Gautham Reddy; Sonali Paul; Anjana Pillai; Michael Charlton; Jeanne M Farnan Journal: Hepatol Commun Date: 2021-07-28