April 18, 1997

Aging population drives demand for nephrologists

Aging population drives demand for nephrologists

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Dr. Julia Breyer confers with Dr. Michael Walls, a clinical fellow in Nephrology

Predicted growth in the number of patients requiring dialysis for end-stage renal disease during the next decade may require nearly double today's number of practicing nephrologists.

The expected influx of aging baby boomers – who will begin to reach age 65 in the year 2010 – will drive the increased demand, nephrologists say.

In an effort to meet this predicted shortfall, Vanderbilt University Medical Center has begun a vigorous recruiting effort to help bolster the ranks of the nation's nephrologists, according to Dr. Julia A. Breyer, associate professor of Medicine in Nephrology.

She is urging Vanderbilt University School of Medicine students to consider specializing in nephrology and has begun to expand the size of VUMC's nephrology training program.

"This year we have five fellows in training for practice careers in nephrology and next year we will have seven. So we are trying to expand the size of our training program to meet the needs of patients," said Breyer.

"It is predicted that there is going to be a very severe shortage by the year 2010."

Nephrology as a subspecialty requires two years of demanding training after a doctor's residency in either Internal Medicine or Pediatrics.

Currently, 170 nephrologists per year are trained in the United States. That number needs to rise considerably to meet the need, said Breyer.

"Unlike other subspecialties where it is predicted that there will be too many doctors under managed care, nephrology has the room to grow. Nephrology has always worked under a capitated system and has done very well under that system. So, we have a lot of experience in the managed care environment," said Breyer.

Nephrology as a specialty began in the 1960's when dialysis first became available to people whose kidneys had failed. Many of the nephrologists who started practicing in the 60's are now beginning to retire, leaving a widening hole in the ranks of practicing nephrologists.

According to Breyer, the need for dialysis due to end-stage renal disease is likely to rise due to three trends in the United States: longer lifespans, the aging of the baby-boomer generation and continuous advancements in medical care.

"The simple fact is that people are living longer and more of them are needing dialysis because we have drastically reduced mortality from other diseases," said Breyer.

As less people die from infections and diseases like tuberculosis, the tide of people who suffer from end-stage renal disease grows, with no anticipated slowdown in sight, Breyer said.