Critical Gap Between Supply and Demand for Endocrinologists

The ongoing shortage of endocrinologists in the United States may soon be affecting greater numbers of patients, and new strategies and policies are urgently needed to meet the demand for adult endocrinologists, according to the latest projections.

A workforce study of adult endocrinologists was first published back in 2003. Now, more than 10 years later, an updated report has been released, and the data are not encouraging. The recently published study projects a significant shortage of adult endocrinologists over the next 10 years.¹

The new report suggests there is a shortage of about 1,500 adult full-time endocrinologists and 100 pediatric full-time endocrinologists. Although the researchers found that in 2011, there were 5,496 board-certified adult endocrinologists — a 52% increase over the number of endocrinologists in 1999 — the demand for adult endocrinologists is growing.

Significant increases in rates of obesity and diabetes, the number of adults aged older than 65 years and other factors are major contributors. The report shows, for example, that diabetes care by endocrinologists represents 46% of coded visits. 

“There has been a shortage, and this has been known for 10 years,” study author Robert Vigersky, MD, from the Diabetes Institute at Walter Reed National Military Medical Center in Bethesda, Md., told Endocrinology Advisor. “It is a problem. There is going to be a widening gap between the demand and the supply through 2025.”

Moreover, as medicine becomes continually more complex and treatment modalities increase exponentially, the ability of primary care providers to treat endocrine problems will become limited.

Unless policy changes are put in place, there could be a significant decline in the overall quality of care for many patients with endocrinopathies, said Dr. Vigersky.

Problems for Patients and Providers

Currently, the average wait time to see an endocrinologist is 37 days. Dr. Vigersky, who is also a past president of the Endocrine Society, noted that wait times will likely increase because endocrinopathies tend to be more prevalent in older adults, and the number of adults aged older than 65 years is rising rapidly.

The concern is that the workforce shortage will impair access to care for not only diabetes but also lipid disorders, thyroid disorders, osteoporosis, pituitary disease and adrenal disease.

“Because of the shortage of endocrinologists, patients won’t be able to get the expertise of the endocrinologist, and with time, patients’ health will suffer,” Dr. Vigersky said. “It would take a growth rate of 14% a year over the next 5 years in the number of fellowship positions to close the gap. That is a huge number because the training programs are all full.”

However, the shortage is not just hurting patients. Endocrinologists are also feeling the strain, according to Dr. Vigersky.

“Endocrinologists are affected by the shortage because they are discouraged that they can’t offer care. Patients have complex issues, and it takes time [to diagnose and treat them],” he said.

The recent passage of the Patient Protection and Affordable Care Act (PPACA) may soon be leading to even more increased demand for endocrinologists, according to Lisa Fish, MD, president-elect of the Endocrine Society.