The United States is facing a serious shortage of physicians, largely due to the growth and aging of the population and the impending retirements of older physicians. While medical schools areto increase enrollment by 30 percent, the 1997 cap on Medicare support for graduate medical education (GME) has stymied the necessary commensurate increases in residency training, creating a bottleneck for the physician workforce.
Aconducted for the AAMC by IHS Inc., predicts that the United States will face a shortage of between 40,800-104,900 physicians by 2030. There will be shortages in both primary and specialty care, and specialty shortages will be particularly large.
These shortages pose a real risk to patients. Because, projected shortages in 2030 need to be addressed now so that patients will have access to the care they need.
Fixing the doctor shortage requires a. This includes innovations such as team-based care and better use of technology to make care more effective and efficient. AAMC-member medical schools and teaching hospitals have been leading the movement to work better in teams with other health professionals like nurses, dentists, pharmacists and public health professionals. These institutions also are developing the new knowledge of what works in health care – not only reading the textbooks – but writing the textbooks to advance the delivery of care.
Even with all of these changes, the data clearly show that reforms alone will not eliminate the doctor shortage.
As part of the multi-pronged approach to alleviating the doctor shortage we also need additional federal support to train at least 3,000 more doctors a year by lifting the cap on federally funded residency training positions. Teaching hospitals are operating 10,000 residency positions without Medicare support, but cuts to Medicare and other clinical reimbursements jeopardize the ability of teaching hospitals to cross-subsidize with clinical revenue these positions.
The AAMC strongly supports bipartisan GME legislation introduced in both the House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2017 (; ), which takes an important step towards alleviating the physician shortage by gradually providing 15,000 Medicare-supported GME residency positions over a five-year period. However, legislation alone will not relieve the doctor shortage.
In addition, the AAMC supports non-GME incentives and programs, including, , and , which are used to recruit a diverse workforce and encourage physicians to practice in shortage specialties and underserved communities.
An outline of key GME and workforce challenges and opportunities facing academic medicine.
A special feature appearing in the January 2016 issue of The American Journal of the Medical Sciences written by AAMC Executive Vice President Atul Grover, MD, PhD; AAMC Chief Health Care Officer Janis Orlowski, MD, MACP; and Clese Erikson, MPAff.
A series of motion graphic videos that provide an introduction to Medicare and GME reimbursement and explain some of the complicated regulatory processes related to how GME payments work.
An explanation of IME payments, which provide an additional payment to a teaching hospital for every Medicare case paid in recognition of the extra costs teaching hospitals incur in caring for patients as part of their teaching mission.