We Need More Doctors Than We Are Producing, Study Says

An Association of American Medical Colleges (AAMC) study evaluating projected trends in the physician workforce over the next decade revealed that the demand for physicians continues to grow faster than the physician supply. Due to a variety of factors including retirement rates and supply shortages, the study indicated that physician shortfalls could reach almost as high as 100,000 by 2025.

Method

To project the supply and demand for the physician workforce, the AAMC engaged IHS, Inc. to evaluate multiple supply and demand models. The study was premised, in large part, upon data from the 2013 American Medical Association (AMA) physician masterfile. The models took into account current shortages in primary care and psychiatry based on the federal government’s Health Profession Shortage Area analyses for primary care and mental health. Supply scenarios were also modeled on changing retirement patterns. The demand model was designed to simulate demographic changes as the population grows and ages. Changes in levels of insurance coverage, due to health coverage expansion under the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), were also factored into the demand models.

Findings

Among the key findings was the fact that, if demand continues to outpace supply in the physician workforce, by 2025, there will be a shortfall of between 46,100 and 90,400 physicians. Although the study projected that physician supply will increase slightly in the next decade, growing demand will increase faster. The projected shortfalls for primary care physicians fell between 12,500 and 31,100 physicians, whereas the demand for non-primary care doctors is expected to exceed supply by 28,200 to 63,700 physicians. The models projected that the ACA, when fully implemented, will increase physician demand by about 16,000 to 17,000 physicians over the projected supply increase. Additionally, the study revealed that a third or more of the physician workforce could retire within the next decade.

Changes

The study indicated that for each of the shortfall projections, the numbers on the lower end of the projection can be attributed to scenarios where advanced practice clinicians play an increased role in providing health care. Due to changes in payment methodologies and the fact that the supplies of advanced practice nurses (APRNs) and physician assistants (PAs) are projected to increase substantially in the coming decade, the researchers suggest that the loss of physician supply could be mitigated.

Variables

Regardless of these mitigating factors, the study projects a significant disparity in the future demand and supply of physicians. The study indicates that several unknowns will dictate the degree of the disparity between the supply and demand. Those unknown variables include: “(1) how physician retirement patterns might change over time based on economic factors, work satisfaction, trends in health and mortality, and cultural norms regarding retirement; (2) whether younger physicians will continue to have similar work-life balance expectations as older cohorts; (3) how clinician staffing patterns are likely to evolve over time; and (4) the effects of different payment models.”