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Generational Differences in Practice Patterns of Dermatologists in the United States
Implications for Workforce Planning
Christine C. Jacobson, MD;
Jack S. Resneck, Jr, MD;
Alexa Boer Kimball, MD, MPH
Arch Dermatol. 2004;140:1477-1482.
Objective To examine the effect of age and other demographic factors on dermatologists’ practice characteristics.
Design Anonymous practice profile survey.
Participants Dermatologist members of the American Academy of Dermatology Association.
Main Outcome Measures Analyzed survey questions included information about legal practice entity, geographic area served, weekly patient care hours, patients seen per hour, and scope of patient care activities.
Results Of 4090 surveys sent, 1425 (35%) were returned. As the age of the cohorts increased, the percentage practicing in solo practices increased (range, 21%-39%), as did the percentage serving urban areas (range, 31%-46%). Measures of physician productivity increased in the older age cohorts; however, age was not a significant factor after controlling for other variables. More patient-hours per week were associated with male sex (P < .001), solo practices (P < .001), and non–urban-based practices (P = .04), whereas a greater number of patients per hour was associated with non–rural-based practices (P = .02) and male sex (P = .03). As the cohorts progressed in age, more time was spent practicing medical dermatology. The number of hours spent practicing cosmetic dermatology peaked in the 41- to 50-year-old cohort (P = .03).
Conclusions Practice patterns differ significantly among dermatologists of different ages. As the current cohorts age and new dermatologists emerge from training, changes in scope of practice and generational differences in productivity are likely to cause a contraction in the effective supply of dermatologists, which has important implications for dermatology workforce planning.
Author Affiliations: Department of Dermatology, Stanford University School of Medicine, Palo Alto, Calif (Drs Jacobson and Kimball); and Department of Dermatology and Institute for Health Policy Studies, University of California, San Francisco, School of Medicine (Dr Resneck). Dr Kimball is now with the Dermatology Clinical Trials Unit, Massachusetts General and Brigham and Women’s Hospitals, Boston.
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