Transparent, Regular Data Vital to Reworking How We Think About Workforce Supply

by Andrew J. Tompkins, MD, MBA •

Meaningful Supply Metrics

But even if we study our specialty’s workforce routinely, what constitutes an adequate supply? For decades, we’ve used the number of otolaryngologists per 100,000 population as the basis for determining an adequate workforce supply. Every specialty and organization uses this number.

Following the same methodology others have used through exact training number projections, I produced a workforce supply projection of 3.61 otolaryngologists per 100,000 population for the year 2025. This would seem to point to an oversupply—a shocking one at that, given previous demand estimates. In the last article, I showed how this supply metric has increased significantly over time. I also highlighted the significant advanced practice provider (APP) growth that further increases our productivity. But something is missed in all of this.

This supply metric of 3.61 simply represents a number of people serving another number of people. The truth is that supply and demand are more complex. Supply input factors such as age, demographics, generational attitudinal shifts toward work, the scope of our specialty, competition, the scope of one’s practice and specialty training, technology, electronic health records, burnout, reimbursement, APPs, and willingness to travel all affect one’s ability and willingness to supply work. Because all of these supply inputs constantly change over time, we can’t even meaningfully compare the number of otolaryngologists per 100,000 metric over time, as we’ve been doing for decades. It’s like comparing apples and oranges.

Further to that point, demand inputs, which affect the denominator of the traditional supply metric, are always changing. Do we think workforce demand hasn’t changed with the Affordable Care Act, high deductible health plans (HDHPs), the general cost of care, and COVID-19, or that demand is the same in all geographic locations? Even if we hold all supply inputs constant over time, if demand is shifting under our feet or differs across regions, the same number of otolaryngologists per 100,000 population won’t necessarily reflect our ability to meet patient demand over time. I believe this traditional supply metric should be abandoned as a descriptor of meaningful information.

We need something that involves a measure of patients’ access to our services, as the 3.61 metric tries to do, but is comparable over time. What’s the one thing we can measure where all these supply and demand factors coalesce, so we don’t have to measure and model them out individually? It all boils down to wait time.