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Projecting the Supply of Practicing Urologists in the United States through 2030
Raymond Fang, MSC, MASC1, Scott Gulig, MSC1, William Meeks, MA1, Howard B. Goldman, MD2, Sherri Donat, MD3, Jennifer Anger, MD4, Neal Shore, MD5, Benjamin Breyer, MD6, Sanoj Punnen, MD7, Kevin R. Loughlin, MD8, Christopher Saigal, MD9, Brain Matlaga, MD10, Heddy Hubbard, PHD1, J. Quentin Clemens, MD11.
1American Urological Association, Linthicum, MD, USA, 2The Cleveland Clinic, Cleveland, OH, USA, 3Memorial Sloan Kettering Cancer Center, New York, NY, USA, 4Cedars-Sinai Health Associates, Beverly Hills, CA, USA, 5Atlantic Urology Clinics, Myrtle Beach, SC, USA, 6University of California San Francisco, San Francisco, CA, USA, 7University Of Miami Urology, Miami, FL, USA, 8Brigham And Women's Hospital, Boston, MA, USA, 9UCLA Medical Center, Los Angeles, CA, USA, 10Johns Hopkins Medical Institutions, Baltimore, MD, USA, 11The University of Michigan Medical Center, Ann Arbor, MI, USA.

BACKGROUND:
We sought to provide an estimate of the current and future size of the nation’s urologist workforce.
METHODS:
Self-reported planned retirement age was collected from the American Urological Association (AUA) 2014 Census. Planned retirement age increases as people age and thus cannot be directly used for predictions. Instead, we used a microsimulation model which controlled variance in planned retirement age as a way to address the observed discrepancy between stated and observed retirement age. This was used to project urologist supply from 2016 to 2030. The approach simulated the likely retirement decisions in each future year based on the adjusted planned retirement age for all 11,990 practicing urologists in 2015. Based on AUA’s 2015-2019 resident match, about 320 residents were expected to graduate and join the workforce each year. We assumed this level of entry would remain consistent. The U.S. population projection by the US Census Bureau was used as a proxy measure of population demand for urologic care. Urologist-to-population ratios were calculated to reflect projected urologist demand.
RESULTS:
The number of practicing urologists in the United States was projected to decrease more rapidly from 2016 to 2020 because more than one-fourth of current practicing urologists are aged 65 or over. After this time frame, the number was projected to stay relatively flat as baby boomers move out of the workforce. Meanwhile, the U.S. population is projected to increase by 10.9% from 2016 to 2030 per the U.S. Census Bureau, resulting in a reduction of the urologist-to-population ratio from 3.42 per 100,000 population in 2016 to 2.81 in 2030. Two hundred additional urologists would need to be added to the workforce each year to keep up with future population growth.
CONCLUSIONS:
The supply of urologists is projected to decrease from 2016 to 2030 - with a steep decline in the next few years due to retirement. These findings assume future urologists maintain similar work hours. As younger urologists who may work fewer hours than their predecessors enter the workforce, even more providers will be needed. To maintain the current care level, policies addressing the growing aging population are needed through either training more urologists or adopting a team approach with more physician extenders.


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