Otolaryngology–Head and Neck Surgery Physician Work Force Issues

OBJECTIVE: To predict future trends in the otolaryngology workforce and propose solutions to correct the identified discrepancies between supply and demand. STUDY DESIGN: Economic modeling and analysis. SETTING: Data sets at national medical and economic organizations. SUBJECTS AND METHODS: Based on current American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and National Residency Matching Program data sets, population census data, and historical physician growth demand curves, the future otolaryngology workforce supply and demand were modeled. Adjustments were made for projected increases in mid-level providers, increased insurance coverage, and the potential effects of lifestyle preferences. RESULTS: There are currently approximately 8600 otolaryngologists in the United States. Estimated demand by 2025 is 11,127 based on projected population growth and anticipated increase in insurance coverage. With an average retirement age of 65 years and no increase in PGY-1 positions for the specialty, the number of otolaryngologists in 2025 will be approximately 2500 short of projected demand. This shortfall will not be adequately compensated by mid-level providers performing less intensive services and may be increased by lifestyle preferences and changing demographics among medical students and residents. The current geographic maldistribution of otolaryngologists is likely to be exacerbated. CONCLUSION: The specialty needs to actively plan for the coming otolaryngologist shortage and train mid-level providers within the specialty. Failure to plan appropriately may result in a reduction in scope of practice of high-intensity services, which will likely remain a physician prerogative. Given the limited likelihood of a significant increase in residency slots, strong consideration should be given to shortening the base otolaryngology training program length.