Healthcare Trend Watch — Physicians are in short supply, too

This post is taken from an article by Robin L. Rose, MBA VP, Healthcare Resource Group, HealthStream, where she looks ahead at the coming year, with an eye to big picture trends that could have a significant impact on how we provide and experience care.

There Is Also a Physician Shortage

Jeff Lagasse, Associate Editor of Healthcare Finance, sums up the issue of the physician shortage as follows, “The looming physician shortage represents a dire situation for the state of healthcare in the U.S., as many experts predict that demand for health services will soon exceed the industry’s capacity to provide care. The underlying reasons are a complex stew of aging baby boomers, physician burnout, and the widespread closure of rural hospitals, not to mention the declining number of medical residency slots available to new graduates” (Lagasse, 2018).

A new study by the Association of American Medical Colleges (released in 2018) showed statistics that were more ominous than those predicted a year earlier (Gooch, 2018):

1. The 2018 report projects a shortage of 42,600 to 121,300 physicians by 2030. This compares to the 2017 report, which projected a 2030 shortage of 40,800 to 104,900 physicians. This year’s projections take into account recently revised federal Health Profession Shortage Area designations for primary care and mental health, the AAMC said.
2. The U.S. faces a potential shortage of 14,800 to 49,300 primary care physicians by 2030. This is higher than the projected shortfall in the 2017 report — a shortage of 7,300 to 43,100 primary care physicians by 2030. AAMC said differences in estimations regarding the projected growth in the supply of physician assistants and advanced practice registered nurses contributed to the higher numbers in the 2018 report, as did PCP supply and demand trends, among other factors.
3. The U.S. faces a potential shortage of 33,800 to 72,700 physicians in non-primary care specialties. This includes a potential shortfall of 20,700 to 30,500 physicians in 2030 for surgical specialties. AAMC attributed the projections to an aging population requiring more complex care as well as a stagnant supply of surgical specialists and other factors.
4. AAMC cites population growth and aging as the primary drivers of the projected physician shortage from 2016 to 2030. The AAMC analysis accounted for projections suggesting the U.S. population will grow nearly 11 percent by 2030, with the population of Americans older than 65 increasing by 50 percent. The organization also accounted for the potential influence of physician retirement in its projections. More than one-third of all currently active physicians will be older than 65 in the next 10 years.
5. Improved access to care would increase the need for physicians. The AAMC estimates suggest the nation would have needed 31,600 more physicians in 2016 if people living in non-metropolitan areas and the uninsured used care the same way as those with coverage in metropolitan areas.

Unlike what we have seen with the nursing shortage, the dearth of physicians appears to be more widespread throughout the U.S., with only a handful of states predicted to have a surplus in coming years (DHHS, 2016).

Projected differences between each state’s 2025 supply and its 2025 demand range from a shortage of 3,060 FTE primary care physicians in Florida to a surplus of 890 FTE physicians in Massachusetts. Thirty-seven states are projected to have a shortage of primary care physicians in 2025, with 12 of these states having a deficit of 1,000 or more FTEs (DHHS, 2016). 

One recent outcome of the physician shortage is state-to-state competition to entice physicians to stay put after they have finished their training. Medical schools, hospitals, and state legislators are forgiving student loan debt, establishing mentorships, and doing whatever it takes to keep physicians newly finished with their residency in their states. On the high end, California—a state with many open positions—keeps about 70% of residents and fellows trained in-state. Smaller states like New Hampshire, where jobs are more difficult to find, retain 28% of doctors after training (The DO Staff, 2018).

Additional Healthcare Trends to Watch

Other trends identified in this article include:

• Amazon is becoming a major disrupter in many areas of healthcare
• Healthcare costs are becoming scarier than the illness itself.
• We need to prepare for new health risks from weather and other disasters.
• Artificial Intelligence (AI) is dramatically changing healthcare
• We are finally addressing population health.
• CMS is changing course.
• We need more joy in healthcare work.
• The nursing shortage is getting worse.
• Digital healthcare organizations are emerging.

References

DHHS, “State-Level Projections of Supply and Demand for Primary Care Practitioners: 2013-2025,” U.S. Department of Health and Human Services (DHHS), Health Resources and Services Administration, National Center for Health Workforce Analysis. 2016, https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/primary-care-state-projections2013-2025.pdf

DO Staff, “Physician shortages have states offering perks to new doctors. Is it working?” American Osteopathic Association, Jan. 16, 2018, https://thedo.osteopathic.org/2018/01/physician-shortages-states-offering-perks-new-doctors-working/

Gooch, Kelly, “Why America’s physician shortage could top 120k by 2030: 5 things to know,” Becker’s Hospital Review, April 11, 2018, https://www.beckershospitalreview.com/hospital-physician-relationships/why-america-s-physician-shortage-could-top-120k-by-2030-5-things-to-know.html

Lagasse, Jeff, ‘Physician shortages mean doctors have to learn to use new technologies,” Healthcare Finance, June 21, 2018, https://www.healthcarefi­nancenews.com/news/physician-shortages-mean-doctors-have-learn-use-new-technologies