An aging population and growing disease burden will require a large and specialized health care workforce by 2025.

As the US population ages, the increasing prevalence of chronic disease and complex medical conditions will have profound implications for the future health care system. We projected future prevalence of selected diseases and health risk factors to model future demand for health care services for each person in a representative sample of the current and projected future population. Based on changing demographic characteristics and expanded medical coverage under the Affordable Care Act, we project that the demand for adult primary care services will grow by approximately 14 percent between 2013 and 2025. Vascular surgery has the highest projected demand growth (31 percent), followed by cardiology (20 percent) and neurological surgery, radiology, and general surgery (each 18 percent). Market indicators such as long wait times to obtain appointments suggest that the current supply of many specialists throughout the United States is inadequate to meet the current demand. Failure to train sufficient numbers and the correct mix of specialists could exacerbate already long wait times for appointments, reduce access to care for some of the nation's most vulnerable patients, and reduce patients' quality of life.

[1]  Deborah Carr,et al.  America's Aging Population: Trends and Uncertainties , 1996 .

[2]  B. Hillner,et al.  Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  K. Rodysill Increasing physician productivity using a physician extender: a study in an outpatient group practice at the Mayo Clinic. , 2003, The Journal of medical practice management : MPM.

[4]  A. Chandra,et al.  The Productivity of Physician Specialization: Evidence from the Medicare Program. , 2004, The American economic review.

[5]  B. Starfield,et al.  The effects of specialist supply on populations' health: assessing the evidence. , 2005, Health affairs.

[6]  R. Phillips,et al.  Adding more specialists is not likely to improve population health: is anybody listening? , 2005, Health affairs.

[7]  Terry S. Field,et al.  Knowledge, patterns of care, and outcomes of care for generalists and specialists , 1999, Journal of General Internal Medicine.

[8]  A Mark Fendrick,et al.  Value-based insurance design. , 2007, Health affairs.

[9]  Michael O'Grady,et al.  Projecting the Future Diabetes Population Size and Related Costs for the U.S. , 2009, Diabetes Care.

[10]  T. Bodenheimer,et al.  Confronting the growing burden of chronic disease: can the U.S. health care workforce do the job? , 2009, Health affairs.

[11]  T. Dall,et al.  Outcomes and lessons learned from evaluating TRICARE's disease management programs. , 2010, The American journal of managed care.

[12]  D. Williamson,et al.  Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence , 2010, Population health metrics.

[13]  J. Rosenzweig,et al.  Diabetes disease management in Medicare Advantage reduces hospitalizations and costs. , 2010, The American journal of managed care.

[14]  J. Cromwell,et al.  Results of the Medicare Health Support disease-management pilot program. , 2011, The New England journal of medicine.

[15]  K. Bertakis,et al.  Patient-Centered Care is Associated with Decreased Health Care Utilization , 2011, The Journal of the American Board of Family Medicine.

[16]  C. Forrest,et al.  Dropping the baton: specialty referrals in the United States. , 2011, The Milbank quarterly.

[17]  Kenneth S Boockvar,et al.  Recent trends in chronic disease, impairment and disability among older adults in the United States , 2011, BMC geriatrics.

[18]  M. Roizen Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement From the American Heart Association , 2012 .

[19]  T. Dall,et al.  The current and projected economic burden of Parkinson's disease in the United States , 2013, Movement disorders : official journal of the Movement Disorder Society.

[20]  Estimated demand for women's health services by 2020. , 2013, Journal of women's health.

[21]  D. Holtzman,et al.  Supply and demand analysis of the current and future US neurology workforce , 2014, Neurology.