Looming Doctor Shortage Could Impact Patient Care

A multipronged solution would include more residency positions, innovation in health care delivery, and greater use of technology, experts say.
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A rapidly growing and aging population and the potential retirement of thousands of experienced physicians could lead to a shortage of as many as 120,000 doctors by 2030, according to new data released by the AAMC.

Using sophisticated economic modeling, the 2018 update of The Complexities of Physician Supply and Demand: Projections from 2016 to 2030 shows demand far outpacing supply in both primary and specialty care.

“The doctor shortage is real and significant,” says Janis M. Orlowski, MD, AAMC chief health care officer. “It is particularly serious for the kind of medical care that our aging population will need.”

Approximately 10,000 Americans turn 65 every day, according to the Pew Research Center. Consequently, the over-65 population will increase by 50% by 2030, putting a strain on the current health care delivery system. Older adults have traditionally used more health care and specialty services than younger populations due to a higher incidence of chronic conditions and age-related illnesses, the AAMC report notes.

At the same time, one-third of practicing physicians will themselves turn 65 within the next decade; when these physicians decide to retire could have a great impact on the doctor shortage, Orlowski says.

Shortage looms despite changing delivery systems

The AAMC has released its workforce projection report annually since 2015, and the 2018 report is consistent with projections from previous years.

Key findings include:

  • A projected shortfall of between 14,800 and 49,300 primary care physicians
  • A projected shortfall of between 33,800 and 72,700 nonprimary care specialists
  • A dearth of surgical specialists, which is of significant concern given anticipated demand for heart surgeries and other life-saving procedures among aging Americans

The report details even more dramatic shortages if disparities in health care utilization among minority, rural, and uninsured populations are addressed. For instance, researchers looked at a scenario in which people living in non-metropolitan areas and people without insurance used care the same way as insured individuals in metropolitan areas. The result: 31,600 additional physicians would have been needed in 2016, with nearly half of those in the South.

“The doctor shortage is real and significant. It is particularly serious for the kind of medical care that our aging population will need.”

Janis M. Orlowski, MD
AAMC chief health care officer

Researchers with global information company IHS Markit, which conducted the analysis on behalf of the AAMC, took into account numerous health care scenarios for the projections, including the proliferation of retail health clinics and the expanding role of advanced practice registered nurses and physician assistants. They also considered how achieving population health goals, such as reducing obesity and diabetes, would affect the doctor shortage. None of those scenarios would significantly change the need for more physicians in the near term, experts say.

“As we work on improving certain chronic diseases, you might think that the need for physicians goes down, but it actually goes up because people live longer,” Orlowski says.

Multipronged approach to solutions

Since 2002, medical schools have increased enrollment by nearly 30%. But training more physicians is likely just part of the solution.

Innovation in care delivery systems, a greater use of technology, more efficient use of all members of a patient’s health care team, including greater use of advanced practice registered nurses and physician assistants, and an increase in federal support for residency training are all needed to address the shortage, says Orlowski.

The AAMC continues to advocate for increased federal support for residency training, which has been frozen since 1997. Bipartisan legislation before Congress—the Resident Physician Shortage Reduction Act of 2017 (H.R. 2267; S. 1301)—would provide an additional 15,000 Medicare-supported residency positions over five years.

“As our medical schools and teaching hospitals work to increase enrollment, enhance medical education, and develop new care delivery models, our policymakers must expand federal support if we are to solve the impending physician shortage,” says AAMC President and CEO Darrell G. Kirch, MD.