HealthMarch 17, 2020

The physician shortage: How bad is it, and what's the impact on doctors?

By: Whitney J. Palmer

Worries about the impending physician shortage have loomed large in healthcare for more than a decade. There's no doubt the United States is on track to suffer a lack of both primary care physicians and specialists within the next decade or so, but how bad the shortfall will be  and its ultimate effect  are cloudy.

Regardless of how big the gap between physician supply and patient demand is, though, it's clear that doctors will feel the impact of a less robust workforce.

The numbers problem

The Association of American Medical Colleges (AAMC) has tracked the impending physician shortage for years. The organization's most recent data, published in 2019, projects a dearth of doctors between 46,900 and 121,900 by 2032.

This problem is one that affects all areas of medical practice. While primary care doctors will likely feel the biggest pinch  between 21,000 and 55,200 physicians  specialists won't be immune. They can anticipate a lack of between 24,800 and 65,800 providers: 1,900 to 12,100 medical specialists; 14,300 to 23,400 surgical specialists; and 20,600 to 39,100 other specialists, including pathologists, neurologists, radiologists and psychiatrists.

Although the physician shortage is a nationwide problem, not all areas of the country will be affected equally, according to AAMC data. Facing the greatest demand for doctors is the South, where the current shortage stands at 31,400, while the Midwest ranks second with 12,900 too few physicians. Conversely, supply and demand are roughly equal in the West, and the Northeast has a 23,900-doctor surplus.

But even in the face of such large numbers and uneven physician dispersal, the shortage problem might not be as dire as it's been described, at least from the patient perspective. Another survey, conducted in 2019 by the Texas Medical Center Health Policy Institute, analyzed the impact of the dwindling physician population based on how easily patients can receive medical care. And getting appointments doesn't seem to be a big issue.

The survey culled responses from 2,000 patients and 750 physicians. According to patient responses, only 19% reported struggling to schedule a new visit with a primary care physician, and only 15% had problems getting in to see a specialist.

The impact on Doctors

The bulk of attention in the physician shortage discussion tends to focus on how it will impact patients. But as a doctor, you could be greatly affected by such a steep drop in numbers over the next several years as well. The following are just some of the changes you might see in how you practice.

Postponing retirement

Just as the general public is aging, so are physicians. By 2032, according to the AAMC, the over-65 population will climb by 48%. Doctors will make up part of that group, with more than 40% of providers falling into the age bracket within the next 10 years. While most physicians of this age would traditionally consider retirement, roughly 80% of providers told the Texas Medical Center survey that they would consider working longer to meet patient needs, at least under certain circumstances, including increased time with patients and bolstered income.

Reliance on nonphysician providers

As you potentially find yourself surrounded by fewer physician colleagues in the future, you'll likely see your partnerships grow with physician assistants and nurse practitioners. With the AAMC predicting a 16% growth in the demand for healthcare services by 2032, the supply of these nonphysician providers is expected to grow at about six times that rate during the same time frame.

Practicing in underserved areas

Given that the physician shortage unevenly impacts the country, it's possible that new doctors could encounter a more stringent requirement for practicing in low-access areas for two years after completing their residency training. This would increase the number of providers in many areas, making it easier for underserved patients nationwide to get the medical care they need.

Preparing to survive the shortage

The aging population and improvements in care for chronic conditions will inevitably increase the need for healthcare services. Along with having fewer providers, practicing physicians must take steps to successfully weather the expected greater demand for their skills. An editorial published on Doximity's Op-Med offered several suggestions to help you prepare:

  • Carefully analyze whether the organization you're considering working for already has a physician shortage. If so, you'll face greater pressures to meet patient needs.
  • Consider more than your current and future financial compensation when choosing to accept a position. If that's your only litmus test, you could find yourself shackled to a job that requires a heavier patient load than you're capable of or willing to handle.
  • Look at other factors that could affect the doctor shortage in the state where you're working. Is the state's medical board punitive in nature, and what is the malpractice risk? If those factors are negative, the shortage there could become worse as physicians move to different locations.

Ultimately, as a practicing physician or resident finishing up training, it's critical to keep the looming shortage on your radar. A 30% increase in medical school enrollment since 2002 does mean more physicians are coming, as the AAMC reports, but it can take more than seven years for new providers to enter the market. Until then, understanding the realities and challenges of the situation can help you continue to provide quality patient care in a demanding market.

Whitney J. Palmer
Lippincott® Medicine
Lippincott is a leading international medical publisher of professional health information for practitioners, faculty, residents, students, and healthcare institutions with a full suite of essential medical products, from books and journals to digital solutions.
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