The Evolving PHM Workforce: Shortages and Opportunities

INTRODUCTION. Entering our third decade as a career pathway in pediatrics, and 6th year as a pediatric subspecialty, Pediatric Hospital Medicine (PHM) has become a popular career choice. Recent estimates suggest that anywhere between 3000-4400 physicians identify as pediatric hospitalists in the United States.1 Inpatient care is provided in either freestanding children’s hospitals, children’s hospitals within hospitals, or community hospitals with or without pediatric units. Harrison et al created a figure (Figure 1) depicting the overall PHM workforce.2 In2 In addition to provision of clinical care ranging from newborn medicine to general and specialty inpatient care of infants through young adults, pediatric hospitalists make noteworthy contributions to health service research, patient safety, medical education, quality improvement, and health system leadership. Annual physician turnover is higher in hospital medicine than in many other specialties, with a mean turnover rate of 10.9% in 2019, and may be higher post-pandemic.3 Retention, job satisfaction, and sustainability of the workforce are essential components of any program.4 Faculty departures are expensive; recruiting and hiring physicians to replace a departing physician can carry substantial impacts including financial costs, fracturing of professional relationships, and shifting the clinical burden to remaining members of the healthcare team.3 An understanding of the factors influencing the workforce are important to optimizing coverage models, professional fulfillment and retention.