Resneck Jack S, Tierney Emily P, Kimball Alexa Boer
Department of Dermatology, Institute for Health Policy Studies, University of California, School of Medicine, San Francisco, California, USA.
J Am Acad Dermatol. 2006 Feb;54(2):211-6. doi: 10.1016/j.jaad.2005.10.013.
There is a perception among many academic dermatologists that departments of dermatology face severe challenges with recruitment and retention of faculty. In an era when evidence points to a shortage of dermatologists and residency graduates have plentiful private practice offers in almost every geographic area, some fear that academic programs will face even steeper challenges attracting and keeping enough dermatologists on staff.
To compare the practice patterns of academic dermatologists with those of the dermatology workforce in other settings, data from the American Academy of Dermatology 2002 Practice Profile Survey were analyzed (1425 respondents, 35% response rate).
The mean age of academic dermatologists (45.6 years) was younger than that of those in other practice settings (51.9 years solo practice, 49.0 years multispecialty group), and older age cohorts were significantly less likely to be working in academics (P < .001). Academic physicians were much more likely than those in solo practice or dermatology-only groups (62.2% vs 18.3%-39.4%) to report that their institution or practice was seeking new dermatologists. The average waiting time for new patient appointments varied from a low of 31.1 days in solo practices to a high of 55.9 days in academic practices. Academic dermatologists saw 32% to 41% fewer patients per week, but spent much more time (24.1 vs 5.5-8.6 h/wk) participating in research, hospital consults, medical writing, administrative activities, and teaching than dermatologists in any other setting.
Academic dermatologists reflected a relatively small proportion of survey respondents, and may not be representative of the nation's dermatology faculty (although the percentage of academics in the survey was similar to that in the overall workforce). Possible response biases could also have affected the survey results.
The survey results identify a number of differences between the practice patterns of academic dermatologists and their colleagues in other settings, and suggest that academic departments of dermatology may be facing unique workforce challenges.
许多皮肤科专业学者认为，皮肤科在招聘和留住教员方面面临严峻挑战。在一个有证据表明皮肤科医生短缺且住院医师毕业生在几乎每个地理区域都有大量私人执业机会的时代，一些人担心学术项目在吸引和留住足够数量的皮肤科医生方面将面临更严峻的挑战。
为了比较学术皮肤科医生与其他环境中皮肤科工作人员的执业模式，对美国皮肤科协会2002年执业概况调查的数据进行了分析（1425名受访者，回复率35%）。
学术皮肤科医生的平均年龄（45.6岁）比其他执业环境中的医生年轻（私人执业为51.9岁，多专科组为49.0岁），年龄较大的人群在学术机构工作的可能性显著较低（P <.001）。与私人执业或仅皮肤科组的医生相比，学术医生更有可能（62.2%对18.3%-39.4%）报告其所在机构或执业机构正在招聘新的皮肤科医生。新患者预约的平均等待时间各不相同，私人执业最短为31.1天，学术机构最长为55.9天。学术皮肤科医生每周看诊的患者数量少32%至41%，但与其他环境中的皮肤科医生相比，他们花在参与研究、医院会诊、医学写作、行政活动和教学上的时间要多得多（每周24.1小时对5.5-8.6小时）。
学术皮肤科医生在调查受访者中所占比例相对较小，可能无法代表全国的皮肤科教员（尽管调查中学者的比例与整个工作人员中的比例相似）。可能的回复偏差也可能影响了调查结果。
调查结果确定了学术皮肤科医生与其在其他环境中的同事在执业模式上的一些差异，并表明皮肤科的学术部门可能面临独特的劳动力挑战。
