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    Original Investigation
    Pathology and Laboratory Medicine
    July 16, 2020

    Reevaluation of the US Pathologist Workforce Size

    Author Affiliations
    • 1Department of Pathology, Duke University Medical Center, Durham, North Carolina
    • 2College of American Pathologists, Washington, DC
    • 3Department of Pathology, University of Texas Southwestern Medical Center, Dallas
    • 4Eugene McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas
    • 5US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Workforce, Rockville, Maryland
    • 6Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
    • 7American Board of Pathology, Tampa, Florida
    • 8Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
    • 9Department of Pathology, The George Washington University Medical Center, Washington, DC
    • 10Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee
    • 11College of American Pathologists, Northfield, Illinois
    • 12Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston
    JAMA Netw Open. 2020;3(7):e2010648. doi:10.1001/jamanetworkopen.2020.10648
    Key Points español 中文 (chinese)

    Question  What is the current size of the US pathologist workforce?

    Findings  This analysis found that the American Medical Association’s Physician Masterfile listed 21 292 active pathologists as of June 2019 compared with 12 839 anatomical and clinical pathologists reported by the Association of American Medical Colleges for 2017 and exceeded all previously published estimates in the past decade.

    Meaning  Accurate physician workforce assessment for all specialties may require a reexamination of the methods used in producing current and previous estimates.

    Abstract

    Importance  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.

    Objective  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.

    Main Outcomes and Measures  Number of physicians classified as pathologists.

    Results  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.

    Conclusions and Relevance  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.

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