In a recent update to their report, The Complexities of Physician Supply and Demand, the Association of American Medical Colleges (AAMC) revealed details about a projected shortage of physicians in the United States. The projected shortage ranges from 46,900 to 121,900 physicians by 2032 (1). The range given by the AAMC is due to factors that cannot be known at this time (which will be addressed later), but what is known is that the physician shortage is happening now, and it will only get worse.
One of the biggest contributing factors to the physician shortage is an aging physician workforce. One-third of all currently active physicians will be over the age of 65 in the next decade. When these physicians retire, they will leave a significant gap in available medical care. Some of these physicians may retire early, some may decide to continue working for a few years, and others may decide to continue working with reduced hours. All these factors contribute to the range in the projected shortage, but all projections point to the very real problem that the aging physician workforce will help create.
Another contributing factor to the growing physician shortage is the adoption of healthier lifestyles. Cigarette smoking is down to 14% of all adults 18 years or older (2). Also, more people are engaging in regular exercise and eating a well-balanced diet. This means that people are living longer, and more physicians are needed to treat them.
One other factor leading to the physician shortage is the current cap on federally funded residency training positions. All physicians must complete a hands-on graduate medical education (GME) to be licensed and practice independently. The Balanced Budget Act of 1997 froze the number of GME slots paid for with federal funds over fears of creating a doctor surplus, and it has remained the same ever since, even though medical schools have increased enrolment by nearly 30% since 2002, and the population of the U.S. has increased by 50 million (3).
While the AAMC’s report is alarming, there are courses of action that can help reduce future physician demand.
One approach is passing legislation to allow more federally funded spots in GME facilities to keep up with our growing population that is living longer. The Resident Physician Shortage Reduction Act of 2019 will increase the number of residency positions eligible for Medicare support by 15,000 slots above the current caps (4). This will make a significant impact on the demand for physicians, but more will need to be done.
Another approach to help meet the increasing demand for physicians is to loosen restrictions on Advanced Practice Clinicians (APCs). There are over 115,000 Physician Assistants and 234,000 Nurse Practitioners in the U.S., and both roles are projected to grow between 30 - 35% in the coming decades (5). Expanding the APC Scope of Practice will help reduce the workload of physicians, alleviate symptoms of burnout, and increase timely access to care for patients.
Hiring physicians on J-1 visas is another way to combat the increasing physician shortage. More than 25% of physicians in training or residency are international medical graduates. Physicians on J-1 visas might receive a Conrad 30 waiver which allows them to stay in the United States for three years to work with sponsoring facilities in areas with the most demand for physicians. There are currently 30 waivers available for each state every year, but new legislation called the Conrad State 30 and Physician Access Reauthorization Act will give each state additional waivers, create new employment protections for physicians in the program, and streamline the green card process of participating physicians (6).
Retaining a physician recruiting firm can also help address the increased demand for physicians. Because they are in high demand, new physicians are seeking more competitive compensation packages. This means in addition to a competitive salary, physicians are expecting incentives such as bonuses, relocation assistance, and medical school debt repayment. Negotiating these compensation packages is complicated. Retaining a physician recruiting firm allows an industry expert to handle the negotiations for you. The Medicus Firm has completed 26.02% of its searches in less than 90 days, and 29.24% of its searches in less than 120 days. Because of its consultative guidance, personalized service, and ongoing communication with clients, the Medicus Firm has won the Best of Staffing Client Satisfaction award seven times in the last nine years, and for four years running.
(2) Current Cigarette Smoking Among Adults in the United States, Centers for Disease Control and Prevention
(3) What Can Be Done About the Coming Shortage of Specialist Doctors?, U.S. News & World Report
(4) Fact Sheet: The Resident Physician Shortage Reduction Act of 2019, American Hospital Association.
(5) Can the advanced practice clinician fix healthcare?, Becker’s Hospital Review