Trends in the US and Canadian Pathologist Workforces From 2007 to 2017
Authors: Jason Y Park
David M Metter
Terence J Colgan
Charles F Timmons
Stanley T Leung
Journal: JAMA Network Open (2019)
Discipline: CLINICAL MEDICINE
Keywords: US pathologist workforce; trends; 2007-2017; physicians; radiologists
Affiliations: Department of Pathology, University of Texas Southwestern Medical Center, Dallas., Department of Pathology, Children's Health, Dallas, Texas., Department of Lab Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada., LifeLabs, Toronto, Ontario, Canada., Incyte Diagnostics, Seattle, Washington., Eugene McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas.

Abstract:  Importance: The current state of the US pathologist workforce is uncertain, with deficits forecast over the next 2 decades. Objective: To examine the trends in the US pathology workforce from 2007 to 2017. Design, setting, and participants: A cross-sectional study was conducted comparing the number of US and Canadian physicians from 2007 to 2017 with a focus on pathologists, radiologists, and anesthesiologists. For the United States, the number of physicians was examined at the state population level with a focus on pathologists. New cancer diagnoses per pathologist were compared between the United States and Canada. These data from the American Association of Medical Colleges Center for Workforce Studies' Physician Specialty Data Books and the Canadian Medical Association Masterfile were analyzed from January 4, 2019, through March 26, 2019. Main outcomes and measures: Numbers of pathologists were compared with overall physician numbers as well as numbers of radiologists and anesthesiologists in the United States and Canada. Results: Between 2007 and 2017, the number of active pathologists in the United States decreased from 15 568 to 12 839 (-17.53%). In contrast, Canadian data showed an increase from 1467 to 1767 pathologists during the same period (+20.45%). When adjusted for each country's population, the number of pathologists per 100 000 population showed a decline from 5.16 to 3.94 in the United States and an increase from 4.46 to 4.81 in Canada. As a percentage of total US physicians, pathologists have decreased from 2.03% in 2007 to 1.43% in 2017. The distribution of US pathologists varied widely by state; per 100 000 population, Idaho had the fewest (1.37) and the District of Columbia had the most (15.71). When adjusted by new cancer cases per year, the diagnostic workload per US pathologist has risen by 41.73%; during the same period, the Canadian diagnostic workload increased by 7.06%. Conclusions and relevance: The US pathologist workforce decreased in both absolute and population-adjusted numbers from 2007 to 2017. The current trends suggest a shortage of US pathologists. 

Retracted: No

PubPeer comments:
 This article needs to be retracted ASAP. The senior author already admitted it is a flawed study. https: jamanetwork.com journals jamanetworkopen fullarticle 2768341 , 
 This article is incorrect. This study used AAMC data to make conclusions about the pathologist workforce. However, the senior author published a follow-up study in 2020 which found that...  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. https: jamanetwork.com journals jamanetworkopen fullarticle 2768341 Thus, the results and conclusions of this study are wrong. , 
 This article states that  The Association of American Medical Colleges (AAMC) Physician Specialty Data Books (2008-2018) were the primary data source. However, the senior author of this paper then published a study in 2020 stating that  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. https: jamanetwork.com journals jamanetworkopen fullarticle 2768341 Thus, the results discussion conclusions of this study are meaningless, if you exclude so many pathologists. In fact the senior author states,  The 40% difference between the AMA count (nu2009=u200921 292) and the AAMCu2019s most recent report (nu2009=u200912 839) is substantial; however, the AAMC count includes only a subset of the pathology workforce. ,