AAMC increases estimate of physician shortage: 8 things to know

The U.S. faces a shortage of physicians ranging between 61,700 and 94,700 over the next decade, according to a new report from the American Association of Medical Colleges.

This report updates a 2015 projection that estimated the nation would need between 46,100 and 90,400 physicians by 2025, though it is still below a 2010 estimate that projected a shortage of 130,600 physicians by 2025.

This year's report uses the same microsimulation model and scenarios as used for last year's projections, but it includes updates to supply and demand data and refined medical school graduate data, and it more fully integrates the effects of the growing ranks of physician assistants.

Perhaps most striking is the addition of an analysis on the needs of underserved Americans that shows how many more physicians the country would need if these patients were able to fully utilize healthcare. These numbers are not included in the overall projections because they only provide estimates for 2014 levels of care.

"These updated projections confirm that the physician shortage is real, it's significant, and the nation must begin to train more doctors now if patients are going to be able to receive the care they need when they need it in the near future," AAMC President and CEO Darrell Kirch, MD, said in a statement.

Here are eight things to know about AAMC's updated findings.

1. The overall physician shortage of 61,700 to 94,700 physicians by 2025, no matter the scenario, is in line with 2015 estimates, according to the AAMC. The differences between this and last year's estimate are merely due to updated data and improvements to the estimation process.

2. Primary care shortages are expected to range 14,900 to 35,600 by 2025. This is "directionally consistent" with the 2015 projected shortfall of 12,500 to 31,100 physicians, according to AAMC. Note that the updated projection also took adult primary care-trained hospitalists out of the primary care physician category because it may have skewed the projections for primary care physicians.

3. Non-primary care specialties are expected to need between 37,400 and 60,300 additional providers by 2025. This projection is also in line with projections from 2015.

4. Surgical specialists comprise the only category of physicians — among primary care physicians, medical specialists and other specialists — that is expected to decline by 2025. In all other categories, the number of physicians is growing, but demand is outpacing supply. Surgical specialties that will be affected include ophthalmology and urology. AAMC estimates the shortfall for these physicians to range 25,200 to 33,200 by 2025.

5. Due to the large numbers of aging physicians, retirement decisions are expected to have the single greatest impact on supply. More than one-third of physicians will be 65 or older in the next decade, according to AAMC.

6. Increasing demand can be traced to population growth and aging. From 2014 to 2025, the U.S. population is expected to increase by about 8.6 percent. Within that, many Americans will be aging up — the population aged 65 and over is expected to grow 41 percent in that time, according to the report. It follows that the demand for healthcare services that seniors need will be higher than the demand for pediatric services.

7. The effects of the Affordable Care Act on physician demand are small. The AAMC expects this will only increase demand by about 10,000 to 11,000 physicians, or 1.2 percent. This projection reflects a reduction from last year's prediction that effects of the ACA would increase demand by 16,000 to 17,000 physicians.

8. If barriers to care were removed for currently underserved populations and these populations had similar patterns of use to the rest of the population, the AAMC found the nation would have needed as many as 96,200 additional physicians in 2014. The AAMC considered two scenarios to make this projection. The first projected the physician shortfall to be 40,100 if uninsured people and those who live in non-metropolitan areas used healthcare at similar rates to their insured peers in metro areas. The second scenario produced the 96,200-physician shortfall by projecting utilization if everyone used care at the same rates as white, insured populations who live in metropolitan areas.

"When you consider all the people who do not utilize healthcare — despite their need — because of financial, cultural, social or geographic barriers, the physician shortage is actually much bigger. We are very concerned about equity in patient utilization of care and how we can address it going forward," Dr. Kirch said in a statement.

The AAMC notes in its report that estimates are not definitive, but are intended to spark conversation on how to address these issues.

 

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