Much has been written in the past few years about the nephrology workforce crisis. Fellowship positions go unfilled; some recent graduates choose to work as hospitalists instead. However, there are many bright spots on the horizon. Exciting new therapies, such as the sodium-glucose cotransporter-2 (SGLT2) inhibitors, offer the chance to help keep more people from reaching kidney failure. Meanwhile, recent policy advances, especially the Advancing American Kidney Health Executive Order in the United States, will help shift the practice of nephrology toward more comprehensive care of patients living with kidney diseases.
Nephrologists in private practice tend to value their independence and autonomy. In the US healthcare system, however, medicine is a team sport. The majority of US nephrologists are in private practice; it is imperative that their voices be heard in the policy debates. Nephrologists in any practice setting should seek to understand the forces that shape their working world. In this issue of Kidney News dedicated to private practice nephrology, we start to examine some of these interplaying forces. The full scope of the nephrology ecosystem is of course beyond one magazine. As you read this issue, I hope you start to think of some parts of your professional world in a different way.
Every nephrologist I know works hard. My belief is that bringing new nephrologists into our profession requires us to also work smart. If there are areas of our practice that need reimagining, we are the ones to do it. Nephrology is a small workforce; this is an opportunity. There are terrific professional nephrology organizations that will help shape the practice environment in the years to come, and each of them welcomes new members. If one of the questions we raise in this month's issue resonates with you, there is no one better to answer it than you. The Editorial Board welcomes ideas for potential articles or even direct submissions on ways we can all make our field better.