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Table 2—

Supply and demand scenarios

SupplyDemand
Scenario 1 Current fellowship positions and fill rates persist into future. 457 endocrinology positions, 86% filled. 57% are IMGs; 80% of IMGs remain in the U.S. to practice. No change in retirement rates. Demand affected only proportionately with population growth. 
Scenario 2 All of above assumptions. Demand exceeds supply by 15% in 1999 (based on trends in patient visits, waiting times, and benchmarking). 
Scenario 3 All of above assumptions. Demand grows in proportion to population. Modest managed care growth: 3% in 2000–2005; 2% in 2006–2010; 1% in 2011–2015. No growth thereafter. (This growth results in a 2% decline in demand for endocrinologists.) 
Scenario 4 All of above assumptions. Demand grows in proportion to population, except that the over-65 population growth results in a 15% greater increase in the demand for adult endocrinologists (see utilization index and ref. 9). 
Scenario 5 All of above assumptions. 1% per year growth in per capita real income (a 10% increase in real income is associated with a 2–4% increase in demand) (14). 
Scenario 6 All of above assumptions. Prevalence of diabetes grows by 1% per year and endocrinologists’ share grows proportionally. 
SupplyDemand
Scenario 1 Current fellowship positions and fill rates persist into future. 457 endocrinology positions, 86% filled. 57% are IMGs; 80% of IMGs remain in the U.S. to practice. No change in retirement rates. Demand affected only proportionately with population growth. 
Scenario 2 All of above assumptions. Demand exceeds supply by 15% in 1999 (based on trends in patient visits, waiting times, and benchmarking). 
Scenario 3 All of above assumptions. Demand grows in proportion to population. Modest managed care growth: 3% in 2000–2005; 2% in 2006–2010; 1% in 2011–2015. No growth thereafter. (This growth results in a 2% decline in demand for endocrinologists.) 
Scenario 4 All of above assumptions. Demand grows in proportion to population, except that the over-65 population growth results in a 15% greater increase in the demand for adult endocrinologists (see utilization index and ref. 9). 
Scenario 5 All of above assumptions. 1% per year growth in per capita real income (a 10% increase in real income is associated with a 2–4% increase in demand) (14). 
Scenario 6 All of above assumptions. Prevalence of diabetes grows by 1% per year and endocrinologists’ share grows proportionally. 
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