Infectious disease (ID) medicine has a numbers problem. There are not enough providers to adequately meet the current level of patient demands, nor enough trainees in the pipeline to rectify the situation. It’s easy to intuit the many consequences: longer waits for appointments, patients having to travel farther for specialty care, delays in care, or fewer chances to ensure optimal health and disease-state management. The list can be added to, but the end products of the equation are the same – suboptimal patient care, provider burnout, and increased costs for hospitals and facilities.
Consider that more than 80% of counties1 in the United States do not have access to a single ID specialist. Also, consider that in the 2022 National Resident Matching Program (NRMP), infectious disease fellowships nationally had a paltry 56% match rate2 for adult ID training programs and 49% for pediatric ID training programs, while most other specialties, like cardiovascular disease, clinical gastroenterology, and interventional pulmonology filled all or nearly all their residency slots2.
Not enough trainees and not enough established providers, yet the patient need is still there – especially given the continually emerging and evolving challenges hospitals face in dealing with the diversity of ID, including:
- Emerging – and re-emerging – infectious diseases. (E.g., monkeypox, measles, RSV, COVID-19, etc.)
- Seasonal influenza
- New and stronger antimicrobial resistant bacteria due to poor use or patient adherence, over prescription, rampant use of antibiotics in livestock, and few novel agents in development
- Challenges in administering and maintaining robust antimicrobial stewardship programs
What happens when the average person needs ID care and they are in an area or facility with limited options? They must travel long distances to major cities or academic medical centers that have more robust ID programs. or they get transferred from one hospital to another, again often out of their local community. Patient care suffers and there can be harm. It’s not an ideal situation for patients or physicians.
So, what are some solutions that can make immediate and substantial change? At the top of the list: Telemedicine.