Clinical Scorecard: The Decline of the Infectious Disease Specialty and Its Consequences for Healthcare in the U.S.
At a Glance
Category
Detail
Condition
Infectious diseases including pandemic threats and vaccine-preventable illnesses
Key Mechanisms
Antibiotic stewardship, infection prevention, public health surveillance, and outbreak response
Target Population
Patients with complex infections, immunocompromised individuals, and the general U.S. population
Care Setting
Acute care hospitals, long-term care, ambulatory care, public health agencies
Key Highlights
Infectious diseases cause 5–15% of U.S. deaths annually; COVID-19 was the third leading cause of death from 2020–2022.
The ID physician workforce is shrinking, with nearly 50% of training programs unfilled and 80% of U.S. counties lacking ID specialists.
ID specialists improve patient outcomes, reduce hospital stays and costs, and are critical for public health surveillance and antimicrobial stewardship.
Guideline-Based Recommendations
Diagnosis
Utilize infectious diseases consultation for complex infections to improve outcomes and reduce length of stay.
Management
Implement antibiotic stewardship programs led by ID specialists across healthcare settings to combat drug resistance.
Coordinate infection prevention and control efforts in hospitals and public health agencies.
Monitoring & Follow-up
Surveillance of infectious disease threats at local, regional, and international levels coordinated by ID-trained physicians.
Monitor vaccine uptake and emerging infectious threats to guide public health interventions.
Risks
Declining ID workforce threatens patient safety and healthcare infrastructure.
Political interference and harassment of public health workers undermine infectious disease control efforts.
Patient & Prescribing Data
Patients with complex infections and those at risk for antimicrobial resistance
ID consultation leads to optimized antibiotic use, shorter hospital stays, and improved clinical outcomes.
Clinical Best Practices
Engage ID specialists early in the management of complex infections to improve patient outcomes.
Support antibiotic stewardship programs to reduce inappropriate antibiotic use in all care settings.
Advocate for policies that address compensation disparities and reduce administrative burdens for ID physicians.
Promote workforce development and retention strategies including support for international medical graduates.
Ensure protection and support for public health and ID professionals against politicization and harassment.
