The need to see an endo is being discussed in another
thread.
This was posted over in mhd by Gumbo, and I found the
original article here:
http://www.diabetesincontrol.com/res...ryarticle=4643
Practicing endocrinologists are in short supply in many
areas of the country, and the situation only has worsened
since a 2003 study that showed the national supply to be 12%
lower than demand, according to several experts
There are no easy solutions to increase the number of
endocrinologists in practice, they say, because the problems
are deeply embedded in the nature of the specialty and
encompass issues involving training, satisfaction, and
reimbursement. Because of these problems, fewer young
physicians are entering the specialty, while some older
physicians are choosing early retirement.
This shortage may reach a critical stage over the next few
years, with diabetes and obesity cases on the rise at the
same time that many doctors are retiring.
“The crisis is not getting any better,” said Dr. Helena
Rodbard, an endocrinologist in Rockville, Md., who cowrote
the original study. “At the time, the data showed there was
a 12% shortage of endocrinologists, and it was projected to
only keep growing.” She estimated that the shortfall could
be 15% or greater now.
[I did a little further searching and found her paper here:
http://jcem.endojournals.org/cgi/content/full/88/5/1979
A Model to Determine Workforce Needs for Endocrinologists in
the United States Until 2020]
Dr. Hossein Gharib, professor of medicine at the Mayo
Clinic, in Rochester, Minn., and past president of the
American Association of Clinical Endocrinologists (AACE),
went even further. He estimated that there are about 5,000
practicing endocrinologists in the United States, and “to
double that would be a reasonable number. If we had 10,000
endocrinologists, every one of them would be busy and would
have a full practice.”
Dr. Gharib said that the shortage of practicing
endocrinologists is felt the most keenly in the Midwest.
“Jobs for endocrinologists are plentiful, although the east
and west coasts and urban areas are fairly well supported.”
He said new endocrinologists finishing training programs can
easily find more work than they can handle if they move to a
midsize Midwestern city.
“The population we serve has increased dramatically with
the advent of obesity, and with the fact that we are much
more astute in finding diabetes,” he said.
The original endocrinology workforce study looked at the
balance between supply and demand of practicing
endocrinologists between 1999 and projected through 2020.
The study found that there were 3,623 adult endocrinologists
in the workforce in 1999, of whom 2,389 (66%) were in
office-based practice (J. Clin. Endocrinol. Metab.
2003;88:1979-87). Many were older; the median age was 49
years. The study also found that the number of
endocrinologists entering practice fell continuously from
1995 to 1999.
“I think it's extremely attractive, but it is an
intellectual pursuit,” Dr. Rodbard said. “It's not a big
moneymaker. We have very few procedures.”
Added Dr. Rettinger: “Each patient requires a lot of work
and a lot of insight. Reimbursement is less for our
subspecialty. The specialty is attractive to those of us
that are already here, but it may not be as attractive to
those we're trying to draw in.”
And that's a big part of the problem. According to data on
the Web site of the Accreditation Council on Graduate
Medical Education, there are 123 endocrinology programs,
with a total of 564 slots. Of those slots, 507 were
filled--leaving about 11% empty.
Because of declining reimbursement and increasing
hassles--problems common to many specialties that do few
procedures--older endocrinologists are becoming
disillusioned and are leaving.
“Many endocrinologists are retiring at age 60 or 65 because
of the hassles of practice,” Dr. Gharib said. Added Dr.
Rettinger: “A lot of older endocrinologists are leaving the
field earlier than they might otherwise because of paperwork
hassles.”
With endocrinologists in short supply, internists and family
physicians are stepping in to take up the slack in treating
patients with diabetes, hyperlipidemia, and obesity, Dr.
Gharib said. But that doesn't always lead to optimal care,
he said. Dr. Rettinger admitted there are no easy answers to
increasing the number of endocrinologists. However, he said,
making changes to training programs to eliminate mandatory
research could help, and continuing to have a strong
advocacy group will help educate payers and lawmakers and
could lead to improvements.
Cheers, Alan, T2, Australia.
d&e,
metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
Shortage of Endocrinologists Expected to Get Even Worse 
Linear Mode
