Supply and demand analysis of the current and future U.S. neurology workforce

OBJECTIVE: This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025. METHODS: A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of new neurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform. RESULTS: The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ∼18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act. CONCLUSIONS: In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future

Figure e-2

Figure e-2. Depersonalization, emotional exhaustion, and personal accomplishment by weekend responsibilities and se

Supplement e-1: Survey Instrument with MBI redacted

Supplement e-1: Survey Instrument with MBI redacte

e-Supplement 2: e-Tables and Figure e-1 and e-2 Legends

e-Supplement 2: e-Tables and Figure e-1 and e-2 Legend

Supplement e-2: Representative Quotes from Respondents

Supplement e-2: Representative Quotes from Respondent

Figure e-1

Figure e-1. Age distribution of male and female neurologist

Data from: Age and sex differences in burnout, career satisfaction, and well-being in US neurologists

Objective: To examine age and sex differences in burnout, career satisfaction, and well-being in US neurologists. Methods: Quantitative and qualitative analyses of men’s (n = 1,091) and women’s (n = 580) responses to a 2016 survey of US neurologists. Results: Emotional exhaustion in neurologists initially increased with age, then started to decrease as neurologists got older. Depersonalization decreased as neurologists got older. Fatigue and overall quality of life in neurologists initially worsened with age, then started to improve as neurologists got older. More women (64.6%) than men (57.8%) met burnout criteria on univariate analysis. Women respondents were younger and more likely to work in academic and employed positions. Sex was not an independent predictive factor of burnout, fatigue, or overall quality of life after controlling for age. In both men and women, greater autonomy, meaning in work, reasonable amount of clerical tasks, and having effective support staff were associated with lower burnout risk. More hours worked, more nights on call, higher outpatient volume, and higher percent of time in clinical practice were associated with higher burnout risk. For women, greater number of weekends doing hospital rounds was associated with higher burnout risk. Women neurologists made proportionately more negative comments than men regarding workload, work–life balance, leadership and deterioration of professionalism, and demands of productivity eroding the academic mission. Conclusions: We identified differences in burnout, career satisfaction, and well-being in neurologists by age and sex. This may aid in developing strategies to prevent and mitigate burnout and promote professional fulfillment for different demographic subgroups of neurologists

High Resolution Figure 2

Figure 2. Fatigue and overall Quality of Life (QOL) by age and gende

Data from: Age and sex differences in burnout, career satisfaction, and well-being in US neurologists

Objective: To examine age and sex differences in burnout, career satisfaction, and well-being in US neurologists. Methods: Quantitative and qualitative analyses of men’s (n = 1,091) and women’s (n = 580) responses to a 2016 survey of US neurologists. Results: Emotional exhaustion in neurologists initially increased with age, then started to decrease as neurologists got older. Depersonalization decreased as neurologists got older. Fatigue and overall quality of life in neurologists initially worsened with age, then started to improve as neurologists got older. More women (64.6%) than men (57.8%) met burnout criteria on univariate analysis. Women respondents were younger and more likely to work in academic and employed positions. Sex was not an independent predictive factor of burnout, fatigue, or overall quality of life after controlling for age. In both men and women, greater autonomy, meaning in work, reasonable amount of clerical tasks, and having effective support staff were associated with lower burnout risk. More hours worked, more nights on call, higher outpatient volume, and higher percent of time in clinical practice were associated with higher burnout risk. For women, greater number of weekends doing hospital rounds was associated with higher burnout risk. Women neurologists made proportionately more negative comments than men regarding workload, work–life balance, leadership and deterioration of professionalism, and demands of productivity eroding the academic mission. Conclusions: We identified differences in burnout, career satisfaction, and well-being in neurologists by age and sex. This may aid in developing strategies to prevent and mitigate burnout and promote professional fulfillment for different demographic subgroups of neurologists

e-Supplement 3: Representative Quotes from Respondents

e-Supplement 3: Representative Quotes from Respondent