[The demographic profile of Italian nephrologists].

For many years Italy has had more active physicians than most Western countries. However, the numerus clausus introduced in 1986 for entry into medical schools together with a sharp decrease in places available in specialty training have changed the situation dramatically and today several specialties suffer actual shortages. In such a situation, professional demography is crucial to outline possible developments for the medical profession and nephrology in particular. Our analysis of the medical profession as a whole was based on data from OECD (international comparative analysis) and the yearly estimate of the General Accounts Office (Italian NHS employees). For calculation of the nephrologists we used the administrative data of the members of the Italian Nephrology Society (SIN) and a survey run among nephrology units in the Lombardy region. Data for the university system (medical and specialty schools) were provided by the University Ministry. We found that Italy is no longer an outlier in terms of physician density compared with other Western countries. This ''normalization'' conceals the high concentration of doctors in the older cohorts and the insufficient number of new doctors to replace those leaving the profession for retirement or other reasons. These patterns are similar - and often more severe - in the case of Italian nephrologists. The aging and increasingly female population of Italian nephrologists calls for a major task shift of many activities to nurses and other healthcare professionals.