JAMA: Is there really a physician shortage?

Thought leaders from Philadelphia-based University of Pennsylvania and the Association of American Medical Colleges sparred over the existence of a physician shortage in opposing viewpoints published by JAMA last week.

The physician shortage needs to be addressed
The piece from the AAMC, authored by President and CEO Darrell Kirch, MD, and Kate Petelle, a senior writer from AAMC, defended the association's latest projections, which estimate a potential shortfall of 40,800 to 104,900 physicians by 2030. The AAMC uses a multivariable approach to calculating these projections, taking uncertainty about future policy and financing, new care delivery models and technological developments into account.

The No. 1 reason the AAMC believes the U.S. faces a serious and worsening physician shortage is the looming demographic changes. Dr. Kirch and Ms. Petelle note the U.S. population is expected to increase 12 percent by 2030, and increase by 55 percent among those who are 65 years or older. Roughly 10,000 Americans turn 65 years old each day, they wrote. This means the general population is aging — increasing the need for care — and many physicians are aging and looking to retire as well.

What physician shortage?
However, a conflicting viewpoint penned by authors from UPenn's Perelman School of Medicine and Wharton School challenges this, instead suggesting the U.S. has a surplus of physicians.

"A simple calculation estimating the number of physicians needed to care for all U.S. residents suggests no physician shortage," they wrote. They took the number of full-time primary care physicians — just over 388,000 — and applied the Agency for Healthcare Research and Quality's recommendation of patient panel size — between 1,500 and 2,000 patients. "Conservatively, if each of the 388,000 full-time primary care physicians cares for an average of 1,500 patients, they could care for an estimated 583 million people," the authors wrote.

The current U.S. adult population is 240 million. Based on the UPenn calculations, the U.S. only needs 160,000 primary care physicians with panel sizes of 1,500 to care for the current population, indicating a potential surplus based on this calculation method.


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