Pediatrician Workforce Data
Ethan Alexander Jewett, MA Senior Health Policy Analyst August 2005
The Pediatrician Pipeline
General Pediatrics Residents in Training
Source: American Board of Pediatrics, 2004-20051
12000 10000 8000 6000 4000 2000 0
7908 7455
8862 8386 9069
9063
9459 9427 9771
9744 9687
9731
10102
10003
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Number of Pediatric Residency Programs and Residents (end June 30, 2006)
Specialty/ Subspecialty # of Accredited Programs # of Matched Residents Specialty/ Subspecialty # of Accredited Programs # of Matched Residents
General Pediatrics
Adolescent Medicine Neonatal-Perinatal Medicine Pediatric Cardiology Pediatric Critical Care Medicine Pediatric Emergency Medicine Pediatric Endocrinology Pediatric Gastroenterology
204
25 97 48 60 45 67 51
7936
72 525 276 300 238 191 181
Pediatric HematologyOncology
Pediatric Infectious Diseases Pediatric Nephrology Pediatric Pulmonology Pediatric Rheumatology Pediatric Sports Medicine DevelopmentalBehavioral Pediatrics Total
60
62 35 46 25 8 26 859
320
165 95 118 49 12 51 10,529
Source: Accreditation Council for Graduate Medical Education, 2005.2
Career Choices of First-Time Applicants for ABP General Pediatrics Certification
2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 0% 20% 69 65 66 68 68 72 73 72 71 67 64 40% 60% 25 27 24 24 23 21 20 21 22 27 28 80% 4 5 6 5 5 5 5 5 5 5 8 100% General Pediatrics Peds Subspecialties Non-Peds Specialties
Source: American Board of Pediatrics, 2004-2005.1
Growth in the Number of General Pediatricians
80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 1975 1980 1985 1990 1995 2000 2003 Growth in General Pediatricians 22,192 28,803 40,893 36,026 50,620 68,279 62,386
Source: American Medical Association Masterfile , 2003.3
Average Percent of Time in General Pediatrics and Subspecialty (excluding residents)
29.2%
Source: AAP Division of Health Services Research, Periodic Survey of Fellows #57 through #60, 2004.4
70.8%
General Pediatrics Subspecialty
Percent of Pediatricians by Gender
(residents and post-residents)
100.0% 80.0% 67.3% 60.0% 40.0% 20.0% 0.0% Resident Post-Resident 32.7% 45.4% Female Male 54.6%
Source: AAP Division of Health Services Research, Periodic Survey of Fellows #57 through #60, 2004.4
Percent of Pediatricians by Race and Ethnicity (residents and post-residents)
80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% White Asian Black Hispanic Other 19.3% 15.6% 4.8% 4.5% 6.0% 4.5% 2.4% 1.9% Resident Post-Resident
Source: AAP Division of Health Services Research, Periodic Survey of Fellows #59, 2004.4
75.2% 71.1%
International Medical Graduates in General Pediatrics
20,000 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 under 35 35-44 45-54 55-64 65 and over 2,360 5,090 5,561 6,348 4,008 5,702 3,790 1,912 IMGs USMGs All General Pediatricians 16,413 14,053 13,930 11,677 10,356 19,020 17,238
Source: American Medical Source: American Medical Association Masterfile , Association Masterfile , 2003. 2003.3
Average Number of Hours per Week in Professional Activity (excluding residents)
2.9 1.9
Source: AAP Division of Health Services Research, Periodic Survey of Fellows #57 through #60, 2004.4
4.6
Professional Activity
0%
2.0
34.5
34.5
2.9
1.9 4.6
2
Direct Patient Care Administration Academic Medicine Research Fellowship Training
Total hours per week = 45.8
20% 40% 60% 80% 100%
Pediatricians Working Part-Time
28% 30% 25% 20% 15% 10% 5% 0% 1993 2000 Males Females 4% 4% 24%
Source: WL Cull et al, 20025
Percent of Pediatricians by Primary Employment Setting (excluding residents)
10% 15%
12%
Source: AAP Division of Health Services Research, Periodic Survey of Fellows #57 through #60, 2004.4
15%
Solo/2-Physician Practice Group Practice HMO Hospital/Clinic Medical School Other
3%
45%
Percent of Pediatricians by Practice Location (excluding residents)
40.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Practice Location 11.3% 20.5% 28.2%
Source: AAP Division of Health Services Research, Periodic Survey of Fellows #57 through #60, 2004.4
Inner City Other Urban Suburban Rural
Average Physician Compensation in 5 Major Specialties
$300,000 $233,030 $250,000 $200,000 $150,000 $100,000 $50,000 $0 Specialty Pediatrics $148,992 $143,773 $147,810 Internal Medicine Family Medicine Obstetrics/Gynecology General Surgery $269,122
Source: American Medical Group Management Association, 20036
The US is marked by a severe geographic maldistribution of general pediatricians. Except for Hawaii, the 12 states with the best pediatrician-to-population ratios are in New England and the Mid-Atlantic states.
The average pediatricianto-population ratio is one pediatrician for every 1,769 children under 18 years of age. Over 70% of states fall below the national average pediatrician-topopulation ratio.7
Geographic Distribution of General Pediatricians in the US
< 1769 children per pediatrician 1770 – 1999 children per pediatrician Source: Mapping Health Care Delivery for America’s Children Project (US Census 2000, AMA/AOA Masterfiles, 2000)7 2000 – 2999 children per pediatrician
3000 – 3999 children per pediatrician
> 4000 children per pediatrician
Pediatrician-to-Population Ratios
(# of children <18 years per post-GME clinical general pediatrician)n
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana 2,229 2,292 2,193 2,797 1,828 1,966 1,220 1,289 484 1,605 1,914 1,242 4,280 1,770 2,714 Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico 2,514 1,994 1,717 1,143 1,040 2,018 2,234 2,833 1,868 2,759 2,608 3,054 1,577 1,125 2,158 North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia 2,755 1,815 2,680 2,049 1,623 1,227 2,220 3,641 1,930 2,421 2,551 1,236 1,590 2,055 2,068
Iowa
Kansas
3,004
3.300
New York
North Carolina
1,068
1,895
Wisconsin
Wyoming
2,100
3,077
Source: Mapping Health Care Delivery for America’s Children Project (US Census 2000, AMA/AOA Masterfiles, 2000) 7
Pediatrician-to-Population Ratios
(50 US states and the District of Columbia, by rank)
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana 34 36 32 44 18 23 6 10 1 13 21 9 51 16 41 Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico 30 24 15 5 2 25 35 45 19 43 39 47 11 4 31 North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia 42 17 40 26 14 7 33 50 22 37 38 8 12 27 28
Iowa
Kansas
46
49
New York
North Carolina
3
20
Wisconsin
Wyoming
29
48
Source: Mapping Health Care Delivery for America’s Children Project (US Census 2000, AMA/AOA Masterfiles, 2000) 7
For additional information:
Please visit the following AAP Web pages: Committee on Pediatric Workforce (COPW) www.aap.org/workforce COPW Subcommittee on Subspecialty Workforce www.aap.org/workforce/copwssw.htm Women in Pediatrics www.aap.org/womenpeds Division of Graduate Medical Education & Pediatric Workforce www.aap.org/gme Committee on Pediatric Education http://www.aap.org/visit/cope.htm
References
1. American Board of Pediatrics. Workforce Data, 2004-2005. Chapel Hill, NC: American Board of Pediatrics; March 2005. 2. Accreditation Council for Graduate Medical Education Website. Available at: http://www.acgme.org/acWebsite/home/home.asp. Accessed August 9, 2005. 3. Pasko T, Smart DR. Physician Characteristics and Distribution in the US, 2005 Edition. Chicago, Ill: American Medical Association; 2005. 4. American Academy of Pediatrics Website. Periodic Survey of Fellows. Available at: http://www.aap.org/research/periodicsurvey/psof.htm. Accessed August 9, 2005. 5. American Medical Group Association. Physician Compensation: 2003 Medical Group Compensation and Productivity Survey, Median Compensation. Available at: http://www.cejkasearch.com/ content.asp Accessed January 16, 2004. 6. Cull WL, Mulvey HJ, O’Connor KG, Sowell DR, Berkowitz CD, Britton CV. Pediatricians working part-time: past, present, and future. Pediatrics. 2002 Jun;109(6):1015-20. 7. Mapping Health Care Delivery for America’s Children Webpage. Available at: http://www.aap.org/mapping/ Accessed August 9, 2005.