{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:11:16Z","timestamp":1788844276951,"version":"build-2803163510"},"reference-count":40,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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\u2019 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.<\/jats:p>\n                  <jats:p>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.<\/jats:p>","DOI":"10.1210\/jendso\/bvae134","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T01:25:00Z","timestamp":1720747500000},"source":"Crossref","is-referenced-by-count":19,"title":["The Arduous Path Toward Equitable Access to Endocrinology Care"],"prefix":"10.1210","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0572-7538","authenticated-orcid":false,"given":"Giulio R","family":"Romeo","sequence":"first","affiliation":[{"name":"Joslin Diabetes Center, Harvard Medical School , Boston, MA 02215 , USA"},{"name":"Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School , Boston, MA 02215 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Caputo","sequence":"additional","affiliation":[{"name":"Joslin Diabetes Center, Harvard Medical School , Boston, MA 02215 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabela W","family":"Stanescu","sequence":"additional","affiliation":[{"name":"Ambulatory Operation Services, Mass General Brigham, Harvard Medical School , Boston, MA 02215 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamil B","family":"Alkhaddo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Allegheny Health Network , Pittsburgh, PA 15212 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"1","key":"2024082703533598000_bvae134-B1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1056\/NEJMp1512532","article-title":"Accountable health communities \u2014 addressing social needs through medicare and medicaid","volume":"374","author":"Alley","year":"2016","journal-title":"N Engl J Med"},{"key":"2024082703533598000_bvae134-B2"},{"issue":"12","key":"2024082703533598000_bvae134-B3","first-page":"e4887","article-title":"New horizons-addressing healthcare disparities in endocrine disease: bias, science, and patient care","volume":"106","author":"Chin","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2024082703533598000_bvae134-B4","doi-asserted-by":"crossref","first-page":"3112","DOI":"10.1210\/jc.2014-2257","article-title":"The clinical endocrinology workforce: current status and future projections of supply and demand","volume":"99","author":"Vigersky","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2024082703533598000_bvae134-B5","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1210\/clinem\/dgaa134","article-title":"Trends in the endocrinology fellowship recruitment: reasons for concern and possible interventions","volume":"105","author":"Romeo","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2024082703533598000_bvae134-B6","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1001\/jamainternmed.2019.3833","article-title":"Assessment of subspecialty choices of men and women in internal medicine from 1991 to 2016","volume":"180","author":"Stone","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"11","key":"2024082703533598000_bvae134-B7","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1016\/j.eprac.2022.08.010","article-title":"An assessment of diversity, inclusion, and health equity training in endocrinology fellowship programs in the United States","volume":"28","author":"Malek","year":"2022","journal-title":"Endocr Pract"},{"issue":"2","key":"2024082703533598000_bvae134-B8","doi-asserted-by":"crossref","first-page":"e1920482","DOI":"10.1001\/jamanetworkopen.2019.20482","article-title":"Trends in racial and ethnic diversity in internal medicine subspecialty fellowships from 2006 to 2018","volume":"3","author":"Santhosh","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"6","key":"2024082703533598000_bvae134-B9","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1210\/jc.2008-2291","article-title":"Clinical review: prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive review","volume":"94","author":"Golden","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2024082703533598000_bvae134-B10","doi-asserted-by":"crossref","first-page":"E1579","DOI":"10.1210\/jc.2012-2043","article-title":"Health disparities in endocrine disorders: biological, clinical, and nonclinical factors--an endocrine society scientific statement","volume":"97","author":"Golden","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"2024082703533598000_bvae134-B11","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1002\/jbmr.4417","article-title":"Racial and ethnic disparities in bone health and outcomes in the United States","volume":"36","author":"Noel","year":"2021","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2024082703533598000_bvae134-B12","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1001\/archinternmed.2011.722","article-title":"Trends in physician referrals in the United States, 1999\u20132009","volume":"172","author":"Barnett","year":"2012","journal-title":"Arch Intern Med"},{"issue":"4","key":"2024082703533598000_bvae134-B13","doi-asserted-by":"crossref","first-page":"240","DOI":"10.7326\/M16-1056","article-title":"Primary care physician volume and quality of diabetes care: a population-based cohort study","volume":"166","author":"Cheung","year":"2017","journal-title":"Ann Intern Med"},{"issue":"1","key":"2024082703533598000_bvae134-B14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1468-0009.2011.00619.x","article-title":"Dropping the baton: specialty referrals in the United States","volume":"89","author":"Mehrotra","year":"2011","journal-title":"Milbank Q"},{"issue":"25","key":"2024082703533598000_bvae134-B15","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1056\/NEJMp1113569","article-title":"The burden of disease and the changing task of medicine","volume":"366","author":"Jones","year":"2012","journal-title":"N Engl J Med"},{"key":"2024082703533598000_bvae134-B16"},{"issue":"4","key":"2024082703533598000_bvae134-B17","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/PHH.0b013e31829bfa60","article-title":"The relationship between county-level contextual characteristics and use of diabetes care services","volume":"20","author":"Luo","year":"2014","journal-title":"J Public Health Manag Pract"},{"issue":"23","key":"2024082703533598000_bvae134-B18","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMsa2032271","article-title":"Trends in diabetes treatment and control in U.S. Adults, 1999\u20132018","volume":"384","author":"Fang","year":"2021","journal-title":"N Engl J Med"},{"issue":"8","key":"2024082703533598000_bvae134-B19","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.2337\/dc20-0097","article-title":"Differences in U.S. Rural-Urban trends in diabetes ABCS, 1999\u20132018","volume":"44","author":"Mercado","year":"2021","journal-title":"Diabetes Care"},{"issue":"5","key":"2024082703533598000_bvae134-B20","doi-asserted-by":"crossref","first-page":"493.e1","DOI":"10.1016\/j.ajog.2017.01.003","article-title":"Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype","volume":"216","author":"Engmann","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"2024082703533598000_bvae134-B21","doi-asserted-by":"crossref","first-page":"2953","DOI":"10.1210\/clinem\/dgac494","article-title":"Appropriate use of telehealth visits in endocrinology: policy perspective of the Endocrine Society","volume":"107","author":"Vimalananda","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2024082703533598000_bvae134-B22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2337\/dsi21-0018","article-title":"Challenges and opportunities in using telehealth for diabetes care","volume":"35","author":"Crossen","year":"2022","journal-title":"Diabetes Spectr"},{"issue":"7","key":"2024082703533598000_bvae134-B23","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.2337\/dc20-2753","article-title":"Barriers to technology use and endocrinology care for underserved communities with type 1 diabetes","volume":"44","author":"Walker","year":"2021","journal-title":"Diabetes Care"},{"issue":"8","key":"2024082703533598000_bvae134-B24","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.amjmed.2017.02.042","article-title":"Osteoporosis in the Women's health initiative: another treatment gap?","volume":"130","author":"Sattari","year":"2017","journal-title":"Am J Med"},{"issue":"1","key":"2024082703533598000_bvae134-B25","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2337\/dc20-0257","article-title":"A decade of disparities in diabetes technology use and HbA1c in pediatric type 1 diabetes: a transatlantic comparison","volume":"44","author":"Addala","year":"2020","journal-title":"Diabetes Care"},{"issue":"12","key":"2024082703533598000_bvae134-B26","doi-asserted-by":"crossref","first-page":"e214182","DOI":"10.1001\/jamahealthforum.2021.4182","article-title":"Racial, ethnic, and socioeconomic inequities in glucagon-like peptide-1 receptor agonist use among patients with diabetes in the US","volume":"2","author":"Eberly","year":"2021","journal-title":"JAMA Health Forum"},{"issue":"5","key":"2024082703533598000_bvae134-B27","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.jacl.2021.08.001","article-title":"Race\/ethnic and sex differences in the initiation of non-statin lipid-lowering medication following myocardial infarction","volume":"15","author":"Colvin","year":"2021","journal-title":"J Clin Lipidol"},{"issue":"5","key":"2024082703533598000_bvae134-B28","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1210\/clinem\/dgab896","article-title":"Eradicating racism: an endocrine society policy perspective","volume":"107","author":"Dhaliwal","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2024082703533598000_bvae134-B29","doi-asserted-by":"crossref","first-page":"983","DOI":"10.4158\/EP161198.OR","article-title":"PREDICTORS OF NONATTENDANCE AT AN ENDOCRINOLOGY OUTPATIENT CLINIC","volume":"22","author":"Eid","year":"2016","journal-title":"Endocr Pract"},{"issue":"7","key":"2024082703533598000_bvae134-B30","doi-asserted-by":"crossref","first-page":"e2652","DOI":"10.1210\/clinem\/dgaa230","article-title":"Endocrinologist burnout: we need to tackle it and bring joy to work","volume":"105","author":"Gabbay","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2024082703533598000_bvae134-B31","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/1471-2296-10-39","article-title":"Transition from specialist to primary diabetes care: a qualitative study of perspectives of primary care physicians","volume":"10","author":"Brez","year":"2009","journal-title":"BMC Fam Pract"},{"issue":"1","key":"2024082703533598000_bvae134-B32","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1089\/pop.2017.0131","article-title":"Achieving a patient-centered, value-based system of diabetes care in the United States: report on a national stakeholder summit","volume":"21","author":"Nash","year":"2018","journal-title":"Popul Health Manag"},{"issue":"3","key":"2024082703533598000_bvae134-B33","doi-asserted-by":"crossref","first-page":"356","DOI":"10.2337\/cd21-0089","article-title":"Improving quality outcomes: the value of diabetes care and education specialists","volume":"40","author":"Rodriguez","year":"2022","journal-title":"Clin Diabetes"},{"issue":"2","key":"2024082703533598000_bvae134-B34","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.eprac.2023.11.005","article-title":"Overcoming barriers to diabetes management in young adults with type 1 diabetes by leveraging telehealth: a pilot study","volume":"30","author":"Romeo","year":"2023","journal-title":"Endocr Pract"},{"issue":"2","key":"2024082703533598000_bvae134-B35","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1056\/NEJMp2201180","article-title":"Tackling implicit bias in health care","volume":"387","author":"Sabin","year":"2022","journal-title":"N Engl J Med"},{"issue":"11","key":"2024082703533598000_bvae134-B36","doi-asserted-by":"crossref","first-page":"907","DOI":"10.7326\/0003-4819-139-11-200312020-00009","article-title":"Patient-centered communication, ratings of care, and concordance of patient and physician race","volume":"139","author":"Cooper","year":"2003","journal-title":"Ann Intern Med"},{"issue":"1","key":"2024082703533598000_bvae134-B37","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4158\/EP-2017-0079","article-title":"ENDO ECHO IMPROVES PRIMARY CARE PROVIDER AND COMMUNITY HEALTH WORKER SELF-EFFICACY IN COMPLEX DIABETES MANAGEMENT IN MEDICALLY UNDERSERVED COMMUNITIES","volume":"24","author":"Bouchonville","year":"2018","journal-title":"Endocr Pract"},{"issue":"1","key":"2024082703533598000_bvae134-B38","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12909-015-0290-9","article-title":"Addressing disparities in academic medicine: what of the minority tax?","volume":"15","author":"Rodr\u00edguez","year":"2015","journal-title":"BMC Med Educ"},{"issue":"8","key":"2024082703533598000_bvae134-B39","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.eprac.2022.04.005","article-title":"Diversity, equity, and inclusion in endocrinology: a survey and vision for the future","volume":"28","author":"Borgan","year":"2022","journal-title":"Endocr Pract"},{"issue":"4","key":"2024082703533598000_bvae134-B40","doi-asserted-by":"crossref","first-page":"e1909","DOI":"10.1210\/clinem\/dgaa938","article-title":"Casting a health equity Lens on endocrinology and diabetes","volume":"106","author":"Golden","year":"2021","journal-title":"J Clin Endocrinol Metab"}],"container-title":["Journal of the Endocrine Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jes\/advance-article-pdf\/doi\/10.1210\/jendso\/bvae134\/58546823\/bvae134.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jes\/article-pdf\/8\/9\/bvae134\/58818979\/bvae134.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jes\/article-pdf\/8\/9\/bvae134\/58818979\/bvae134.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T23:53:56Z","timestamp":1724716436000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jes\/article\/doi\/10.1210\/jendso\/bvae134\/7713859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":40,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,7,26]]}},"URL":"https:\/\/doi.org\/10.1210\/jendso\/bvae134","relation":{},"ISSN":["2472-1972"],"issn-type":[{"value":"2472-1972","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,9]]},"published":{"date-parts":[[2024,7,15]]},"article-number":"bvae134"}}