July 9, 2019

A Perspective on the Physician Shortage

As the demand increases to recruit physicians in primary care and some specialties the competition between physician recruiting firms, hospitals, and practices is fierce.  In addition, the business of finding top talent can be very challenging due to economic factors such as low unemployment and increased demand for doctors.

Doctor Shortage Predictions

“The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply, according to new data published by the AAMC (Association of American Medical Colleges).”  The AAMC has cited various reasons for this impending shortage such as physician burnout and retirements, aging of the general population as well as the aging of practicing physicians, population increases, expanded coverage under the Affordable Care Act and the lack of newly trained doctors.

AAMC reports that “although medical schools have increased enrollment by 30% since 2002, the 1997 cap on Medicare support for graduate medical education (GME) has stymied the necessary commensurate increases in residency training, creating a bottleneck for the physician workforce.” The Complexities of Physician Supply and Demand: Projections from 2017-2032.  Just last month bipartisan legislation [“Resident Physician Shortage Reduction Act of 2019” (S. 348/H.R. 1763)] was introduced in Congress with the purpose of expanding Medicare funding for additional residency slots and increase the number of trained physicians by 15,000 over the next five years.  Certain states have also voiced concern that not enough newly trained physicians especially in certain specialties will be forthcoming and have reached out to medical schools to increase the number of residency slots.

The US Department of Health and Human Services, Health Resources and Services Administration (HRSA) has also chimed in with warnings specifically in the arena of primary care physician shortages with projections of up to 20,400 physicians in 2020.

Does the Shortage Exist?

These doctor shortage predictions seem dire but are the models used to develop these predictions valid and is there a real shortage? The cry of physician shortages is not new and there has been a plethora of research studies on this subject in the US since the 1930s with the greatest percentage declaring that there is a shortage. Critics of this mentality suggest that there are other issues that must be considered such as time management and efficiency, maldistribution of physicians (i.e. urban vs rural settings), geographic specialty maldistribution, the applicant pool with regard to foreign medical graduates, salary inequities (family medicine low paying compared to a high paying specialist) or should a new doctor go into private practice vs joining a group practice or hospital. Training more physicians will not necessarily correct these problems as there are additional factors to consider.  “Princeton health economist Uwe Reinhardt points out that groups like the AAMC have a self-interest in saying there’s a shortage, to move more money towards the medical schools and the hospitals it represents.”

Even though there are multiple viewpoints on whether there is a lack of physicians the fact remains that physician recruiting firms, hospitals and groups are presented with many challenges to recruit top-notch candidates.

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