Department of Pathology, Duke University Medical Center, Durham, North Carolina.
College of American Pathologists, Washington, DC.
JAMA Netw Open. 2020 Jul 1;3(7):e2010648. doi: 10.1001/jamanetworkopen.2020.10648.
There is currently no national organization that publishes its data that serves as the authoritative source of the pathologist workforce in the US. Accurate physician numbers are needed to plan for future health care service requirements.
To assess the accuracy of current pathologist workforce estimates in the US by examining why divergency appears in different published resources.
DESIGN, SETTING, AND PARTICIPANTS: This study examined the American Board of Pathology classification for pathologist primary specialty and subspecialties and analyzed previously published reports from the following data sources: the Association of American Medical Colleges (AAMC), the Accreditation Council for Graduate Medical Education (ACGME), a 2013 College of American Pathologists (CAP) report, a commercially available version of the American Medical Assoication (AMA) Physician Masterfile, and an unpublished data summary from June 10, 2019.
Number of physicians classified as pathologists.
The most recent AAMC data from 2017 (published in 2018) reported 12 839 physicians practicing "anatomic/clinical pathology," which is a subset of the whole. In comparison, the current AMA Physician Masterfile, which is not available publicly, listed 21 292 active pathologists in June 2019. The AMA Physician Masterfile includes all pathologists in 15 subspecialized training areas as identified by the ACGME. By contrast, AAMC's data, which derive from the AMA Physician Masterfile data, only count physicians primarily associated with 3 general categories of pathologists and 1 subspecialty category (ie, chemical pathology). Thus, the AAMC pathology workforce estimate does not include those whose principal work is in 11 subspecialty areas, such as blood banking or transfusion medicine, cytopathology, hematopathology, or microbiology. An additional discrepancy relates to the ACGME residency (specialties) and fellowship (subspecialties) training programs in which pathologists with training in dermatopathology appear as dermatologists and pathologists with training in molecular genetic pathology appear as medical geneticists.
This analysis found that most sources reported only select categories of the pathologist workforce rather than the complete workforce. The discordant nature of reporting may pertain to other medical specialties that have undergone increased subspecialization during the past 2 decades (eg, surgery and medicine). Reconsideration of the methods for determining the pathologist workforce and for all workforces in medicine appears to be needed.
目前没有一个发布数据的全国性组织，这些数据可以作为美国病理学家劳动力的权威来源。为了规划未来的医疗保健服务需求，需要准确的医生人数。
通过检查为什么不同的已发布资源中会出现差异，来评估目前美国病理学家劳动力估计的准确性。
设计、环境和参与者：这项研究检查了美国病理学会（American Board of Pathology）对病理学家主要专业和亚专业的分类，并分析了以下数据来源的先前发布报告：美国医学院协会（Association of American Medical Colleges，AAMC）、研究生医学教育认证委员会（Accreditation Council for Graduate Medical Education，ACGME）、2013 年美国病理学会（College of American Pathologists，CAP）的一份报告、商业版美国医学协会（American Medical Association，AMA）医师主文件，以及 2019 年 6 月 10 日未公开的数据摘要。
被归类为病理学家的医生人数。
最新的 AAMC 数据来自 2017 年（2018 年发布），报告称有 12839 名医生从事“解剖/临床病理学”工作，这是整体的一个子集。相比之下，目前的 AMA 医师主文件（2019 年 6 月）未公开，列出了 21292 名活跃的病理学家。AMA 医师主文件包含了 15 个亚专业培训领域的所有病理学家，这些领域是由 ACGME 确定的。相比之下，AAMC 的数据来自 AMA 医师主文件数据，仅统计主要与 3 个一般类别病理学家和 1 个亚专业类别（即化学病理学）相关的医生。因此，AAMC 的病理学家劳动力估计不包括那些主要从事 11 个亚专业领域工作的医生，如血液银行或输血医学、细胞病理学、血液病理学或微生物学。另一个差异与 ACGME 住院医师（专业）和研究员（亚专业）培训计划有关，在这些计划中，接受皮肤病病理学培训的病理学家被视为皮肤科医生，而接受分子遗传学病理学培训的病理学家被视为医学遗传学家。
这项分析发现，大多数来源仅报告了病理学家劳动力的部分类别，而不是全部劳动力。报告的不一致性可能与过去 20 年经历了更多亚专业培训的其他医学专业有关（例如，外科和内科）。似乎需要重新考虑确定病理学家劳动力以及医学所有劳动力的方法。
