Pediatric Gastroenterology Workforce Survey, 2003-2004.

BACKGROUND: The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) performed a workforce survey to determine the number, distribution, and work-related activities of pediatric gastroenterologists in the United States of America (USA) and Canada, and compared these findings with the first workforce survey completed in 1996.

METHODS: The survey queried pediatric gastroenterologists in the USA and Canada between November, 2003 and June 2004. To permit the optimal comparison to the 1996 survey data, the original survey was used as a template for development of the current instrument and, when possible, the questions were left unchanged. Additional questions were added to address important contemporary issues not present in the initial survey. Limited income information was also collected. The survey was posted on the NASPGHAN website, and the NASPGHAN membership was notified of the survey by electronic mail via its electronic mail distribution list. This was followed by a three-part postal mail survey to all non-respondents. After the Internet and postal mail requests, all non-respondent physicians were telephoned a minimum of three times. If unsuccessful in contacting the physicians directly, office personnel were queried to facilitate survey completion regarding the provision of pediatric gastroenterology, nutrition or hepatology services in either clinical care or research.

RESULTS: The response rate based on the potential contact list for Part I of the survey was 69%. The final phone call or electronic mail contact of an office staff member with questions regarding gender and delivery of pediatric gastroenterology services yielded a total contact rate of 88%. There were 699 pediatric gastroenterologists identified in North America, as compared with 672 in 1996. If known non-respondents are included, there could be as many as 794 pediatric gastroenterologists. Time spent in clinical activities increased from 60% to 66% in the USA and from 43% to 53% in Canada. The use of nurse practitioners and physician assistants has increased considerably over the past 7 years. Fifty-three percent of respondents feel there are too few pediatric gastroenterologists. Fifty percent of section and practice heads report that they are currently recruiting partners. Limited income information is presented.

CONCLUSIONS: There is currently a self-perceived shortage of pediatric gastroenterologists as compared with 7 years ago, despite a constant proportion of pediatric gastroenterologists per million children. In the USA, nurse practitioners and physician assistants are being increasingly used to fill this need, and physicians in both Canada and the USA have increased the time they spend in clinical care.