A serious shortage of physicians is expected to hit the United States over the next 10 years unless multi-pronged interventions are undertaken, according to a “Viewpoint” article appearing recently in JAMA.
Darrell Kirch, MD, and Kate Petelle, MPhil, representatives of the Association of American Medical Colleges (AAMC) in Washington, DC, say that acute shortages are expected, irrespective of the type of provider setting or geographic location.
Changing demographics
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Demographic change is an important contributor to workplace shortages, the authors note. According to current projections, the US population will increase by 12% between 2015 and 2030. Notably, the population of individuals age 65 and older is predicted to grow by 55%, with a resultant surge in demand for healthcare services for this age group.
They also point out that more than one-third of currently employed physicians will be age 65 or older within a decade. Retirement decisions among these physicians will be an important determinant of physician supply, they say.
Physician supply projections
The 2017 update of physician workforce projections released by AAMC shows a probable shortage of between 40,800 and 104,900 physicians in the United States by 2030. Shortages have already been noted in both urban and rural communities and affect both specialty and primary care.
Nonphysician practitioners: helpful but not a remedy
Dr Kirch and Ms Petelle say that the employment of nonphysician clinicians, such as physician assistants and advanced practice nurses, has been widely touted as a means of satisfying the increasing demand for physicians.
However, they are quick to acknowledge that while an expanded role for nonphysician healthcare professionals “may help mitigate shortages to a certain point,” nonphysician practitioners are not qualified to deliver the exact same services as physicians.
Multipronged solution
A multipronged approach is needed to solve the physician shortage, the authors say. “The US healthcare system is in a transformational moment, representing an important opportunity to develop better practice models, create a culture of interprofessional team-based care, advance medical technology, and develop a diverse healthcare workforce that serves all individuals in the United States,” they write.
They also call for medical schools and residency programs to train an adequate number of physicians to satisfy the growing need. At present, however, caps placed almost 20 years ago on federal Medicare funding for residency training make it difficult to expand graduate medical education. Congress, they add, should raise these caps. Otherwise, there will not be sufficient growth in the number of physicians.
Reference
Kirch DG and Petelle K. “Addressing the Physician Shortage: The Peril of Ignoring Demography.” JAMA. 2017. doi: 10.1001/jama.2017.2714 [Epub ahead of print]
