When it comes to issues in healthcare, the physician shortage probably isn't top-of-mind.
But maybe it should be.
In recent years, the dwindling number of doctors in the United States has become a growing problem and topic of debate among healthcare stakeholders. Survey after survey continues to report what is now being accepted as the obvious:
The nation is in the midst of a growing physician shortage, with many states facing a serious physician drought.
In this article, we dig deeper into the physician shortage crisis that America is facing, including:
- What's causing it.
- Who it affects and why.
- How to solve it.
Read on to learn more.
Since 2015, the Association of American Medical Colleges (AMMC) has been committed to producing annual updates of national physician workforce projections.
By assessing the capacity of the country’s future physician workforce, AAMC’s findings provide stakeholders with insights into changes anticipated in physician workforce supply and demand by 2030.
The following is a list of three key stats highlighted in their 2018 report:
- Projected physician shortage of 42,600-121,300 physicians by 2030.
- Potential primary care physician shortage of 14,800-49,300 physicians by 2030
- Potential shortage of 33,800-72,700 physicians in non-primary care specialties by 2030.
These numbers are concerning, even more so when considering what we know about the COVID-19 outbreak and other pandemic statistics.
So, what explains this staggering decline in medical professionals over the next decade?
Although there is no lone culprit for the physician shortage issue, there are a variety of influential factors contributing to it.
Increase in population
According to AMMC, the population in the United States is estimated to grow by about 11 percent, from 324 million in 2016 to 359 million by 2030. An increase in population ultimately leads to an increase in demand for services, including healthcare services. If nothing is done to increase the number of physicians in order to meet the increasing demand for healthcare services, then naturally the physician shortage crisis will persist.
Increase in the number of seniors
While the population of minors is estimated to grow by only 3 percent, the population of seniors (aged 65 and over) is estimated to grow by 50 percent. A society with relatively more seniors, as the U.S. is expected to have by 2030, has a higher demand for healthcare services used by seniors than the demand for pediatric services. This is because seniors are more susceptible to chronic illnesses than people in other age groups.
High rate of physician retirement
AMMC also projects that over one-third of all presently active physicians will be over 65 years old in the next ten years. Furthermore, studies indicate that there is little interest in primary care by new graduate students. Reports indicate that only 1 out of 6 medical school graduates chose a primary care residency. If these stats are any indicator for future trends, the anticipated physician shortage in the coming years will create an imbalance between the high demand and low supply of healthcare services.
Improved access to healthcare
The Patient and Affordable Care Act, more commonly known simply as the Affordable Care Act (ACA), improves access to healthcare by expanding access to health insurance in the U.S. Findings reveal that there have been significant reductions in the rate of uninsurance among the poor, low-income earners and those who live in Medicaid expansion states. Today, more than 20 million citizens who were previously uninsured have gained coverage.
With more people being able to access healthcare services, the demand is expected to continue rising as time goes by. If the uninsured and those living in non-metropolitan areas sought healthcare services the same way as those with insurance coverage in metropolitan areas, then it’s estimated that the nation will need more physicians.
Although the impact of the physician shortage crisis is visible nationwide, its effects are more intense in rural areas. Studies indicate that patients living in rural areas are 5 times more likely to live in a county with a physician shortage compared to those living in suburban and urban areas.
Since healthcare services for seniors are in higher demand, they’re the most affected by the physician shortage. According to a report by the United Health Group (UHG), the number of adults age 65 or above living with at least one chronic illness is projected to rise from 43 million to 59 million by 2030.
Population aging has a relatively large impact on different medical conditions, including:
- Cardiovascular diseases (such as heart failure).
- Diseases and disorders of the respiratory system (such as pneumonia and obstructive pulmonary disease).
- Disorders of the musculoskeletal system and connective tissue.
- Disorders of the male reproductive system (such as prostate cancer).
Needless to say, patients with these conditions are and will continue to be among the most adversely affected by the country's doctor shortage.
For upcoming generations, the doctor lifestyle doesn't carry the allure it once had.
But given its proximity to the student loan debt crisis, a known contributor to physician burnout, is this really such a surprise?
Fortunately, non-physician clinicians such as physician assistants and nurse practitioners are increasingly expressing interest in primary care. While these non-physician clinicians are well-positioned to address the shortage crisis in primary care, there are some obstacles that prevent them from filling the current primary care gaps. Many states do not grant NPs and PAs the full scope of practice.
If more (or all) states could relax their scope of practice laws, the country would see a significant decrease in physician shortages. Leaning on these non-physician technicians is certainly a cost-effective way to ensure that there are enough physicians to meet the ever-increasing demand for healthcare services.
Of course, this raises a variety of ethical questions regarding qualifications and skill level.
Healthcare is a controversial subject for many reasons. But one area that's up not up for debate is this:
We need more doctors.
To better understand the physician shortage, it helps to review the issues:
- Key stats.
- Root causes and their effects.
- Actionable solutions for the near future.
Barring an extraordinary reversal in these trends, America's doctor shortage will continue to be a major concern for the healthcare industry and the nation as a whole.
Jack is a Creighton University graduate and former advertising creative who has written extensively about topics in personal finance, employee benefits, and technology. You can find Jack's writing on Calendar.com, StartupNation, and Muck Rack.