By Christopher Cheney
By 2034, there will be a shortage of physicians ranging from 37,800 to 124,000, according to a recent report prepared for the Association of American Medical Colleges.
The AAMC has published seven annual supply and demand reports on the physician workforce since 2015. Projected shortages of physicians pose several implications, including limiting access to care, stymying efforts to achieve health equity, and eroding clinician well-being.
The projected physician shortage is a complex challenge that requires urgent action, AAMC President and CEO David Skorton, MD, said in a prepared statement.
“Addressing the physician shortage requires a multipronged solution that starts with educating and training enough physicians to meet America’s needs and includes improving access to care, diversifying the physician workforce, and ensuring our nation is prepared to address current and future public health crises. Now more than ever, the nation must make a long-term investment in the healthcare workforce. The time to act is now,” he said.
This year’s AAMC physician workforce report was prepared by the Life Science division of IHS Markit, a global information company. The analysis was conducted before the onset of the coronavirus pandemic and was updated with trends in healthcare delivery and the physician workforce such as physician work hours and retirement trends.
The report features five key findings:
1. Projected physician shortage by 2034
Demand for physicians is projected to grow faster than supply for more than a decade, with the physician shortage by 2034 set to range from 37,800 to 124,000, the workforce report says.
The shortfall of primary care physicians is projected from 17,800 to 48,000 by 2034.
The shortfall of specialty physicians is projected from 21,000 to 77,100 by 2034, including the following three categories:
- Surgical specialties shortfall from 15,800 to 30,200
- Medical specialties shortfall from 3,800 to 13,400
- Shortage in other specialties ranging from 10,300 to 35,600
2. Demographic drivers
Population growth and aging of the U.S. population are expected to be the primary drivers of demand for physicians from 2019 to 2034, the workforce report says.
“During this period, the U.S. population is projected to grow by 10.6%, from about 328.2 million to 363.0 million. The population under age 18 is projected to grow by 5.6%, which portends low growth in demand for pediatric specialties. The population aged 65 and older is projected to grow by 42.4% — primarily due to the 74.0% growth in size of the population age 75 and older. This trend portends high growth in demand for physician specialties that predominantly care for older Americans,” the report says.
3. Aging workforce
Many physicians are approaching retirement age, and trends in retirement decisions will have a significant impact on the supply of physicians, the workforce report says.
“More than two of five currently active physicians will be 65 or older within the next decade. Shifts in retirement patterns over that time could have large implications for physician supply. Growing concerns about physician burnout, documented in the literature and exacerbated by COVID-19, suggest physicians will be more likely to accelerate than delay retirement. On the other hand, economic uncertainty and any detrimental effect on physician wealth could contribute to delaying retirement,” the report says.
4. Impact of increasing care access
The coronavirus pandemic has heightened concern over health equity and care access, the workforce report says. “COVID-19 has raised awareness of the disparities in health and access to care by minority populations, people living in rural communities, and people without medical insurance.”
If these concerns are addressed, demand for physicians will increase significantly, the report says. “If underserved populations had healthcare use patterns like populations with fewer access barriers, demand would rise such that the nation would be short by about 102,400 (13%) to 180,400 (22%) physicians relative to the current supply. Improving access to care is a national imperative.”
5. Impact of the coronavirus pandemic
COVID-19 will likely impact both supply and demand for physicians, but the effects will be hard to determine for years, the workforce report says.
“The current pandemic has demonstrated that to better ameliorate the morbidity, mortality, and economic impacts of future pandemics, we will need to train (or cross-train) more physicians to alleviate shortages in crucial specialties and settings; approach this ramp-up within a context of equity, diversity, and inclusion; focus on the well-being of the healthcare workforce so that our providers are healthy enough to provide high-quality care to patients; and improve the effectiveness and efficiency of care delivery by using promising technologies and team-based care,” the report says.
The pandemic has exposed weaknesses in the healthcare system and placed a spotlight on the importance of physicians in U.S. medicine, Skorton said.
“The COVID-19 pandemic has highlighted many of the deepest disparities in health and access to healthcare services and exposed vulnerabilities in the healthcare system. The pandemic also has underscored the vital role that physicians and other healthcare providers play in our nation’s healthcare infrastructure and the need to ensure we have enough physicians to meet America’s needs,” he said.
Christopher Cheney is the senior clinical care editor at HealthLeaders.