New Report Predicts Worsening Physician Shortage

What would it be like for a nation to experience a shortage of tens of thousands of physicians?

That’s the situation that the United States is facing in the not-too-distant future, according to a new report from the Association of American Medical Colleges (AAMC), which monitors physician workforce issues.

In fact, researchers predict that the nation could be facing a shortage of physicians that ranges somewhere between 42,600 and 121,300 by 2030.

The 2018 update to The Complexities of Physician Supply and Demand: Projections from 2016 to 2030 details the results of a study conducted for AAMC by IHS, Inc. The study forecasted ongoing shortages in both primary and specialty care. It also predicted larger shortages than last year’s forecast; in 2017, AAMC warned of physician shortages between 40,800 and 104,900 by 2030.

Even more sobering: some feel the new forecast could be a conservative estimate, and that the future vacancy rate for physician jobs could be much higher.

According to Janis Orlowski, MD, AAMC’s chief healthcare officer, AAMC uses statistics from the federal government to make its predictions. The 2018 forecast took into account recently revised information from the Health Resources and Services Administration (HRSA) about providers in primary care and mental healthcare in designated Health Professional Shortage Areas (HPSAs).

“We have always been very conservative as we look at the numbers,” she said. “The federal numbers, in my view, have been low.”

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The latest AAMC report forecasts a shortage of primary care physicians  that could range between 14,800 and 49,300. Meanwhile, a shortage of physicians in surgical specialties could range between 20,700 and 30,500 by the year 2030.

The persistent problem of physician shortages

The latest predictions are not entirely unexpected. The AAMC has been warning of looming physician shortages for a number of years now. As the population grows, more people need healthcare. The AAMC report noted that the general population is expected to grow from 324 million in 2016 to 359 million by the year 2030.

Additionally, the population is aging. A recent report on healthcare and aging by the Stern Center at the University of Pennsylvania predicted that 20 percent of the U.S. population in 2050 will be adults over age 65--up from just 12 percent of the population in 2000.

This increase is significant, because as people get older, they typically need more healthcare services. In fact, many of them will need help managing multiple chronic conditions. And physician retirements are expected to be a major factor in the looming shortage.

According to the AAMC report, more than one-third of the physicians currently active in the workforce will be 65 or older within the next 10 years.

As physicians get older, they begin to contemplate retirement. A looming wave of retirements could further deplete the number of physicians available to care for the larger population--and for the larger numbers of people who need more healthcare as they get older.

RELATED: The Benefits of Locum Tenens Jobs for Retired or Semi-retired Physicians  

The AAMC is beginning work on a new national survey that will focus on physicians’ current and future work plans, including their retirement plans, said Orlowski, with the results, expected to be available next year.

Filling the pipeline: The challenges in medical education  

One of the biggest challenges to address the looming shortage is training doctors now to meet the future need--especially considering the lack of current funding.

The looming shortage of physicians “is dire, but work is being done,” said Orlowski. Medical schools have been stepping up and doing their part to increase the supply of physicians in the pipeline to meet the future demand, said Orlowski.

Between 2007 and 2017, 22 new medical schools opened, and many medical schools have increased their enrollments over the past 15 years or so.

The end result is that medical school enrollment is up by about 30 percent overall since 2002.

But the lack of federal funding to expand residency training spots for those students once they graduate has become a significant problem. Graduate medical education (GME) funding has been capped since 1997, and AAMC has been asking Congress to remove the limits and provide more funding for more residency slots.

In fact, the AAMC maintains that there is a need for federal funding to support the training of an additional 3,750 physicians per year.

AAMC is urging support for the bipartisan Resident Physician Shortage Act of 2017  which would boost the number of doctors in residency positions that are supported by GME funding through Medicare by 15,000 over five years. Orlowski said that she hopes that concerned physicians and others will consider contacting their elected representatives and speaking up for this additional funding.

“You can have an impact by advocating for it with your congresspeople,” she said.

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