According to one recent simulation model, ophthalmology is forecasted to have one of the worst workforce adequacy rankings among medical specialties in the United States by the year 2035. This estimation reflects a significant projected shortage in the number of practicing ophthalmologists in the face of an increasing demand for eyecare services, although the reasons behind these potential shifts remain elusive.
Study design
This observational cohort study used the Health Workforce Simulation Model from the National Center for Health Workforce Analysis to explore projected eye care supply and demand as well as ophthalmology workforce adequacy from 2020–2035. Two models were employed: a status-quo scenario, which assumed the starting supply in 2020 was adequate to meet national demand and that trends seen between 2015–2019 would continue, and a reduced-barriers scenario, which assumed there would be more equivalent access to healthcare in the future due to improved healthcare policies and programs targeting currently underserved populations.
Outcomes
In 2020, there were an estimated 21,250 full-time equivalent (FTE) workers in ophthalmology. By 2035, the status-quo model projected a decrease of 2650 FTEs, equivalent to a 12% decline in the total supply of ophthalmologists. The same model projected an increase in demand of 5150 FTE (+24%). Using a reduced-barriers scenario, the projected total demand increased by 5840 FTE (+25%) from 2020 to 2035. This projection correlated with a 70% adequacy of the ophthalmology workforce to meet demand (vs 92% in 2020), earning ophthalmology the second-lowest projected workforce adequacy in 2035 out of 38 medical and surgical specialties analyzed. When the authors compared workforce adequacy projections by geographic area, the forecast appeared to be even gloomier, estimating an adequacy decline in metropolitan areas to 77% and non-metropolitan areas to 29%.
Limitations
Limitations of this study include the projection model itself and its methods of estimating supply and demand, plus the fact that the data used for the microsimulation were obtained from professional clinical associations, which may lead to forecasting errors. Additionally, the influence of future technological advancements in areas such as telehealth and artificial intelligence systems may impact the accuracy of the projected results.
Clinical significance
These findings suggest that a large, inverse relationship may exist in the future between the number of eyecare clinicians and the prevalence of visual impairment, which could have real world implications for the eye health of the populations that we serve as ophthalmologists. If these projections hold true, patients may likely experience increased rates of preventable vision loss due to an inadequate supply of eyecare professionals to meet care needs.
Financial Disclosures: Dr. Marianeli Rodriguez discloses no financial relationships.