A national paucity of hepatologists: An unprecedented opportunity for interdisciplinary collaboration.

Abstract

The national supply of hepatologists unfortunately mismatches the burgeoning growth of liver disease and thus demand for liver specialists. However, the unmet need for the management of complex liver disease pathology presents a unique opportunity to foster cross-disciplinary collaborations to ultimately improve patient care. All of us would like to think we are indispensable. As a subspecialty of gastroenterology, it is easy to surmise that the depth and breadth of hepatology itself is vast enough that one can easily focus their career exclusively on the management of liver disease. However, many find hepatology an ever-evolving field for which our collective unmet need to serve our communities lies further and further from our grasp. If we conservatively estimate that perhaps 1 in 5 adults in Canada has a chronic liver disease— that is, non-alcoholic fatty liver disease (NAFLD), alcoholic fatty liver disease, viral hepatitis, hemochromatosis, or any of the many other less common conditions we treat—the inadequacy of the hepatology workforce to unilaterally address the public health burden of liver disease becomes all too apparent. Therefore, it is imperative to seek innovative solutions that leverage the strengths of an interdisciplinary approach to optimize the liver health of Canadians. The supply-demand gap is expected to widen in the future, due in part to changing demographics. Indeed, the public health burden of chronic liver disease is projected to increase substantially, much as it has over the past two decades (1,2). As the sizeable baby boomer population ages, rates of cirrhosis will undoubtedly increase from the current twelfth leading cause of death overall and the fifth leading cause of death for patients aged 45–54 years (3). Furthermore, owing to the oft-insidious onset and progression of liver disease, it is telling A national paucity of hepatologists