Addressing the Decline in the Number of Infectious Disease Physicians

The infectious disease (ID) specialty has experienced quite a bit these last few years. And much of it has been very demanding, exhausting, and too much—for some.

It has been nearly 3 years since the shutdown in early 2020. The stress in those early months associated with the pandemic, including treating patients without clinican guidance or therapies, combined with personal concerns of contracting the virus or giving it to loved ones, stuck for quite a while. This may have led to burnout, early retirement, and possibly a lack of interest in the field for aspiring medical providers.

Right now there is a lack of these providers in rural and smaller communities. “Physicians who focus on infectious diseases are uniquely qualified to help prepare for the next pandemic, but 80% of US counties lack a single ID doctor,” Carlos del Rio, MD, FIDSA, president of Infectious Diseases Society of America (IDSA), said in a statement.

According to the statistics from the most recent National Resident Matching Program (NRMP) day—where NRMP releases the eagerly awaited results of all the young medical students who have applied for residency or fellowship training positions in the US—there was only 56% of the adult and 49% of the pediatric ID training programs filled.

The existing shortfall in ID combined with the diminished interest in entering the field could be very problematic for the future in healthcare.

The Health Resources and Services Administration estimates that in 12 years there will be a demand for 15,130 infectious disease specialists in the US, but there will only be an estimated 14,010 ID physicians.

Surveying the Landscape

IDSA commissioned a national poll that was conducted by Big Village last November. They surveyed 1007 adults who were 18 years of age and older. The online omnibus study was conducted three times a week among a demographically representative sample of Americans.

The responses reiterated the need for these valuable specialists. For example, 91% of poll respondents said it was important to have infectious diseases experts in hospitals to protect patients from infections when receiving chemotherapy or surgery like a hip replacement. ID specialists were also viewed as vital to public health preparedness. In the poll, 65% of respondents said increasing the number of people who focus on managing infectious diseases will better prepare the US for the next pandemic.

Could the PREVENT and Pandemics Act Help?

One area where there might be some hope in getting more people into ID is an act introduced in the US Senate last March.

The Prepare for and Respond to Existing Viruses, Emerging New Threats (PREVENT), and Pandemics Act is a bill designed to set up programs to address health preparedness and response.

According to the prospective legislation, “the bill establishes a legislative task force to investigate the COVID-19 pandemic and a White House office to advise on pandemic preparedness and response. It also revises authorities, programs, and other aspects of the Department of Health and Human Services and associated agencies to support preparedness and response activities at all levels of government.”

In addition, the bill includes the following:

• grants related to health disparities and for centers for public health preparedness;
• collection and dissemination of public health data (e.g., genomic sequencing of pathogens);
• workforce programs for public health and related fields;
• the safety and availability of the blood supply;
• research concerning viruses and other pathogens with pandemic potential, vaccines and other medical countermeasures, and the long-term health effects of COVID-19;
• biosafety and security related to biological agents and toxins;
• national security, privacy and information security, and foreign influence in biomedical research;
• the administration of the Strategic National Stockpile; and
• domestic manufacturing of medical countermeasures.

Cultivating the Next Generation of ID Providers
Included in the bill is a specific provision called the BIO Preparedness Workforce Pilot Program that would incentivize health care professionals to choose to focus on infectious diseases. Specifically, the pilot program would incentivize healthcare professionals to pursue careers in ID/HIV and work in underserved areas or certain federal facilities like Ryan White Clinics by providing targeted loan repayment.

Experts say the legislation is crucial to helping shore up the nation’s infectious diseases workforce, medical supply chains, surveillance capabilities and medical countermeasure development.

Loan Forgiveness

Loan forgiveness has been a contentious topic, but the IDSA poll found support for it in a specific area. In fact, 65% of respondents believe the federal government should help pay the loans of medical students who focus on managing infectious diseases and agree to work in rural areas or regions without doctors.

Support for the overall PREVENT and Pandemics Act includes more than 100 health organizations representing patients and healthcare providers according to IDSA.

To read more about the PREVENT and Pandemics Act, go here.