The Supply and Distribution of the Preventive Medicine Physician Workforce

Abstract

Context: Preventive medicine physicians work at the intersection of clinical medicine and public health. A previous report on the state of the preventive medicine workforce in 2000 revealed an ongoing decline in preventive medicine physicians and residents, but there have been few updates since. Objective: The purpose of this study was to describe trends in both the number of board-certified preventive medicine physicians and those physicians who self-designate preventive medicine as a primary or secondary specialty and examine the age, gender distribution, and geographic distribution of this workforce. Design: Analysis of the supply of preventive medicine physicians using data derived from board certification files of the American Board of Preventive Medicine and self-designation data from the American Medical Association Masterfile. Setting: The 50 US states and District of Columbia. Participants: Board-certified and self-designated preventive medicine physicians in the United States. Main Outcome Measures: Number, demographics, and location of preventive medicine physicians in United States. Results: From 1999 to 2018, the total number of physicians board certified in preventive medicine increased from 6091 to 9270; the number of self-identified preventive medicine physicians has generally decreased since 2000, with a leveling off in the past 4 years matching the trend of preventive medicine physicians per 100 000 population; there is a recent increase in women in the specialty; the practice locations of preventive medicine physicians do not match the US population in rural or micropolitan areas; and the average age of preventive medicine physicians is increasing. Conclusions:The number of preventive medicine physicians is not likely to match population needs in the United States in the near term and beyond. Assessing the preventive medicine physician workforce in the United States is complicated by difficulties in defining the specialty and because less than half of self-designated preventive medicine physicians hold a board certification in the specialty.

Public Health and General Preventive Medicine Training: A National Survey

“…More than half of both graduates and residents identified as female, a higher percentage than historical studies reporting a range of 32–36% ( Salive and Parkinson, 1991 , Salive, 1997 , Liang et al, 1995 ). The higher female response rate in our survey may reflect recent nationwide trends of increasing number of females attending medical school ( The Majority of U.S. Medical Students Are Women, New Data Show ); and appears to be in keeping with data reported by a recent survey of PM residents ( Ricketts et al, 2021 ). Approximately 16 % of our participants were International Medical Graduates (IMGs), similar to the 13% active PM IMGs reported in the American Association of Medical Colleges 2020 physician specialty data report ( Active Physicians Who Are International Medical Graduates (IMGs) by Specialty, 2019 ).…”

“…A recent study by Ricketts et al found <50% of physicians who self-identified as a PM specialist had PM board-certification ( Ricketts et al, 2021 ). In their study, they also reported difficulty in assessing the current PM workforce due to the absence of a clear established definition of the PM specialty.…”

“…Moreover, after completing two PM job market surveys in 2001, investigators concluded that GPM board-certification had little to no value for success in the GPM job market ( Nitzkin et al, 2001 ). Despite the seemingly questionable value of PM board-certification in securing a job, the number of physicians with PM board-certification increased from 1999 to 2018 ( Ricketts et al, 2021 ); perhaps indicating increased personal valuation of board-certification by physicians. A respondent in our study also noted that board-certification helped justify dedicated full-time equivalent for public health work.…”

“…Furthermore, reportedly many PM physicians have made one or more career changes ( Pearson et al, 1988 ). This, along with the wide spectrum of career paths among self-designated PM physicians ( Lane, 2000 , Ricketts et al, 2021 ) may partially explain why it is complicated to assess the PM workforce in the United States. ( Self-segregation and division among PM specialists further compound the problem and makes distinct recognition of the specialty by other physicians, public health professionals and the public somewhat difficult ( Jadotte et al, 2019 ).…”

Preventive Medicine for Rural America: Why More Training Programs Must Be Here

“…These authors concluded, "There is extremely little penetration of the PM workforce into rural areas." 3 There is therefore not only a growing national shortage of PM physicians but also a maldistribution.…”