GASTROENTEROLOGY WORKFORCE MODELING

Objective.-To examine the current supply and distribution of gastroent erologists and project future supply under various scenarios to provid e a paradigm for workforce reform. Design.-An analysis of current prac tices and distribution of gastroenterologists and a demographic model, using the 1992 gastroenterology workforce as a baseline, Main Outcome Measure.-Comparison of current supply, distribution, and practice pro files with past data and future projections, using analyses of data fr om the 1993 Area Resource File, 1992 Medicare Part B file, age- and se x-specific death and retirement rates from the Bureau of Health Profes sions, managed care staffing patterns, the National Survey of Internal Medicine Manpower, and the Bureau of the Census. Results.-Rapid growt h in the number of US gastroenterologists has resulted in a gastroente rologist-to-population ratio double that used on average by health mai ntenance organizations. In addition, the work profile of gastroenterol ogists is shared significantly by primary care physicians and other sp ecialists, with the exception of a few specific and uncommon procedure s, Conclusions.-Empirical evidence suggests that, even in the absence of detailed models to describe the desired supply/need balance for gas troenterology, the US health care system and clinicians may benefit fr om a reduction in gastroenterology training programs. The Gastroentero logy Leadership Council endorsed a goal of 25% to 50% reduction in tra inee numbers over 5 years, and recent National Resident Matching Progr am data indicate that a voluntary downsizing process is in full force, This study illustrates a paradigm for workforce planning that could b e useful for other medical specialties.