PDF(Pubmed)
Abstract：
Multiple factors contribute to the widening gap between supply and demand of endocrinology services. In addition to the inadequate growth of the workforce, the inefficient utilization of endocrinologists\' expertise coupled with the rising prevalence of endocrine conditions has generated a crisis in access to specialty care. This mismatch is magnified in underserved communities and among certain racial/ethnic groups that carry a disproportionate burden of chronic diseases, like diabetes and osteoporosis, thus perpetuating the cycle of health disparities in vulnerable populations. Reorienting the framework of endocrine care toward more effective and equitable access will require comprehensive changes in operational processes, system-based policies, and in the diversity of our workforce. Specifically, the progressive transition to outcome-driven, team-based models of care can extend endocrinology services beyond the traditional boundaries of in-office referrals and promote job satisfaction. Further, the implementation of policies that directly tackle structural determinants of health is a prerequisite to a more precise and equitable deployment of specialty care. In this view, the recruitment and professional growth of clinicians underrepresented in medicine along the career ladder, including leadership roles, is a key conduit to revitalize our field and to innovate the delivery of endocrine care across all communities.
摘要：
多种因素导致内分泌服务供需之间的差距扩大。除了劳动力增长不足，内分泌学家的专业知识利用效率低下，加上内分泌疾病患病率上升，在获得专科护理方面产生了危机。这种不匹配在服务不足的社区和某些承担不成比例的慢性病负担的种族/族裔群体中被放大,比如糖尿病和骨质疏松症，从而延续了弱势群体健康差距的循环。将内分泌护理框架调整为更有效和公平的获取，将需要对业务流程进行全面改革，基于系统的策略，以及我们劳动力的多样性。具体来说,逐步过渡到结果驱动，基于团队的护理模式可以将内分泌服务扩展到传统的办公室转诊范围之外,并提高工作满意度.Further,实施直接解决健康结构性决定因素的政策是更精确和公平部署专科护理的先决条件。在这个观点中,沿职业阶梯，医学界代表性不足的临床医生的招聘和专业成长，包括领导角色，是振兴我们领域和在所有社区创新提供内分泌护理的关键渠道。
