The Pathologist Workforce in the United States II. An Interactive Modeling Tool for Analyzing Future Qualitative and Quantitative Staffing Demands for Services

被引:42
作者
Robboy, Stanley J. [1 ]
Gupta, Saurabh [2 ]
Crawford, James M. [3 ]
Cohen, Michael B. [4 ]
Karcher, Donald S. [5 ]
Leonard, Debra G. B. [6 ]
Magnani, Barbarajean [7 ]
Novis, David A. [8 ]
Prystowsky, Michael B. [9 ,10 ]
Powell, Suzanne Z. [11 ]
Gross, David J. [12 ]
Black-Schaffer, W. Stephen [13 ,14 ]
机构
[1] Duke Univ, Med Ctr, Dept Pathol, Durham, NC 27710 USA
[2] Smart Cube, Noida, India
[3] North Shore Long Isl Jewish Hlth Syst, Dept Pathol & Lab Med, Manhasset, NY USA
[4] Univ Utah, Dept Pathol, Huntsman Canc Hosp, Salt Lake City, UT USA
[5] George Washington Univ, Dept Pathol, Washington, DC USA
[6] Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA
[7] Tufts Univ, Sch Med, Dept Pathol, Boston, MA 02111 USA
[8] Novis Consulting, Lee, NH USA
[9] Albert Einstein Coll Med, Dept Pathol, Bronx, NY 10467 USA
[10] Montefiore Med Ctr, Bronx, NY 10467 USA
[11] Methodist Hosp, Dept Pathol & Genom Med, Houston, TX 77030 USA
[12] Coll Amer Pathologists, Policy Roundtable, Washington, DC USA
[13] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA
[14] Harvard Univ, Sch Med, Boston, MA USA
关键词
HEALTH-CARE WORKFORCE; MANAGEMENT; CONSENSUS; WORKLOAD;
D O I
10.5858/arpa.2014-0559-OA
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Context.-Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams. Objective.-To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services. Design.-Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts. Results.-Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value. Conclusions.-Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.
引用
收藏
页码:1413 / 1430
页数:18
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