Original Articles Pathologist Workforce in the United States I. Development of a Predictive Model to Examine Factors Influencing Supply Stanley J. Robboy, MD; Sally Weintraub, MBA; Andrew E. Horvath, MD; Bradden W. Jensen, MD; C. Bruce Alexander, MD; Edward P. Fody, MD; James M. Crawford, MD, PhD; Jimmy R. Clark, MD; Julie Cantor-Weinberg, MPP; Megha G. Joshi, MD; Michael B. Cohen, MD; Michael B. Prystowsky, MD, PhD; Sarah M. Bean, MD; Saurabh Gupta, BPharm; Suzanne Z. Powell, MD; V. O. Speights Jr, DO; David J. Gross, PhD; W. Stephen Black-Schaffer, MD; and additional members of the Workforce Project Work Group  Context.—Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage. Objective.—To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of changing market forces and emerging technologies on the supply of pathologists’ services through 2030. Design.—Data came from various sources, including the literature, College of American Pathologists’ internal data, and primary research through custom-developed surveys for the membership and for pathology practice managers Results.—Through 2010, there were approximately 18 000 actively practicing pathologists in the United States (5.7 per 100 000 population), approximately 93% of whom were board certified. Our model projects that the absolute and per capita numbers of practicing pathologists will decrease to approximately 14 000 full-time equivalent (FTE) pathologists or 3.7 per 100 000 in the coming 2 decades. This projection reflects that beginning in 2015, the numbers of pathologists retiring will increase precip- itously, and is anticipated to peak by 2021. Including all types of separation, the net pathologist strength will begin falling by year 2015. Unless workforce entry or exit rates change, this trend will continue at least through 2030. These changes reflect the closure of many training programs 2 to 4 decades ago and the substantially decreased number of graduating residents. Conclusions.—This comprehensive analysis predicts that pathologist numbers will decline steadily beginning in 2015. Anticipated population growth in general and increases in disease incidence owing to the aging popula- tion, to be presented in a companion article on demand, will lead to a net deficit in excess of more than 5700 FTE pathologists. To reach the projected need in pathologist numbers of nearly 20 000 FTE by 2030 will require an increase from today of approximately 8.1% more residen- cy positions. We believe a pathologist shortage will negatively impact both patient access to laboratory services and health care providers’ abilities to deliver more effective health care to their patient populations. (Arch Pathol Lab Med. 2013;137:1723–1732; doi: 10.5858/arpa.2013-0200-OA) S ince the early 1970s, several high-level analyses have assessed the manpower needs of pathologists either broadly as a specialty, 1–5 or more narrowly in the community practice setting, 6,7 also referred to as private practice. Two analyses 8,9 have examined single pathology subspecialty needs, and two 10,11 have focused in depth on academic health centers (AHCs) (see Table 1 for a complete list of acronyms). While not representative of the discipline as a whole, these surveys of AHCs accurately predicted overall manpower trends, especially in emerging subspecialty areas. Among the findings for these collected studies were predicted increases in numbers of PhD holders providing pathology services, more women and ethnic minorities serving as laboratory professionals, and a high number of pathologists leaving academic practice to enter private practice. In 2009, the College of American Pathologists (CAP), anticipating that health care reform legislation would soon Accepted for publication May 1, 2013. Published as an Early Online Release June 5, 2013. From the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Drs Robboy and Bean); College of American Pathologists, Waukegan, Illinois (Mses Weintraub and Cantor-Weinberg, and Dr Gross); the Department of Pathology, University of New Mexico, Albuquerque, New Mexico (Dr Horvath); the Department of Pathology, Southwest Washington Medical Center, Vancouver, Washington (Dr Jensen); the Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama (Dr Alexander); the Department of Pathology, Holland Hospital, Hol- land, Michigan (Dr Fody); the Department of Pathology, North Shore- Long Island Jewish Health System, Manhasset, New York (Dr Crawford); ACL Labs, West Allis, Wisconsin (Dr Clark); the Department of Pathology, Lawrence General Hospital, Winchester, Massachusetts (Dr Joshi); the Department of Pathology, University of Utah, Salt Lake City (Dr Cohen); the Department of Pathology, Albert Einstein College of Medicine, Bronx, New York (Dr Prystowsky); Grail Research, Mumbai, India (Mr Gupta); the Department of Pathology, The Methodist Hospital, Houston, Texas (Dr Powell); the Department of Pathology, Scott and White Memorial Hospital, Temple, Texas (Dr Speights); and the Department of Pathology, Massachusetts General Hospital, Boston (Dr Black-Schaffer). The authors have no relevant financial interest in the products or companies described in this article. Reprints: Stanley Robboy, MD, Duke University Medical Center, Department of Pathology, DUMC-3712, Durham, NC 27710. (e-mail: stanley.robboy@duke.edu). Arch Pathol Lab Med—Vol 137, December 2013 Pathologist Workforce in the United States—Robboy et al 1723