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Emerging specialist shortage triggers work force review

New studies and anecdotal reports are pointing to growing shortages of doctors who concentrate on caring for children and the elderly.

By Jay Greene, amednews staff. Jan. 22, 2001.

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Mounting evidence of a physician specialist shortage is prompting a federal advisory committee to reconsider work force recommendations that seek to limit the number of physicians in training.

The Council on Graduate Medical Education will meet in April to discuss recent reports that point to a growing shortage of specialists, including anesthesiologists, gerontologists, cardiologists, pulmonologists, urologists, oncologists, gastroenterologists, hematologists and a variety of intensive care physicians.

"The growing swell of anecdotal information has prompted COGME to relook at its assumptions," said David Sundwall, MD, COGME's past chair. "A number of specialties have contacted us with concerns of dire shortages. The worst thing we can do is stand on our principles and do nothing."

Over the past year, anecdotal evidence is increasing that physician shortages are moving from rural and inner-city areas to suburban settings. In California last month, six pediatric specialists flew in a Learjet from Los Angeles to Redding to take care of 40 low-income children who had been waiting months for tonsillectomies, ear drainage tubes and other simple procedures.

Redding, a growing Northern California city of 80,000 with two modern hospitals, is no Appalachia. But Redding is illustrative of a growing number of affluent communities that cannot find enough specialty physicians.

"It's not just a problem, it's a crisis," said Stuart Siegel, MD, director of the Children's Center for Cancer and Blood Diseases at Childrens Hospital in Los Angeles. "California has indeed been hit hard by physician shortages, especially in pediatric subspecialties. We have been recruiting for a head of neonatology for more than two years. We lost two excellent young general pediatric surgeons, and we have yet to recruit replacements." [...]