The impact of the economy and recessions on the marketplace demand for ophthalmologists (an American Ophthalmological Society thesis).

Purpose: To develop a help-wanted index (HWI) to measure trends in marketplace demand for ophthalmologists, to identify the economic drivers of demand, and to determine the impact of economic recessions on the ophthalmology job market.

Methods: Review of physician recruitment advertisements appearing in the journals Ophthalmology, American Journal of Ophthalmology, and Archives of Ophthalmology from January 1980 through June 2006.

Results: Over the 26-year study period a consistent increase in the demand for subspecialists (31% of HWI in 1980 to 80% in 2005) was noted. There was also an increase in the demand for academic ophthalmologists. The need for academic ophthalmologists seems to be correlated with national research expenditure and stock market gains (P = .00191), whereas demand for private practice ophthalmologists seems to be correlated with the national economic well-being, as measured by gross domestic product (GDP) (P < .001). Residency applicants (P = .0128) and fellowship applicants (P = .0198) respond to marketplace demand. During the recessions, the demand for ophthalmologists fell 2 to 3 years after the economic downturn.

Conclusions: Over a 26-year period, HWI data suggest an increased need for subspecialists and academic ophthalmologists. The ophthalmic community has been quick to respond to marketplace demand. National research expenditure, stock market gains, GDP, and discretionary health care expenditure have been associated with the ophthalmology job market. These factors tend to decline with economic recessions. Historically, the demand for ophthalmologists has declined 2 to 3 years following a recession, which may mean lower demand in the near future, given the recent recession.