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Why Is There a Shortage of Doctors in the US?

Physician Shortage in US

Why is there a shortage of doctors? Physician shortage in US: In July 2020, Quartz made a headline about the United States is on the verge of a ‘devastating’ shortage of doctors in US. By the end of the month, the Washington Post wrote that “America is to face a shortage of primary care physicians within a decade or so.” This is however a fact, as estimates from the Association of American Medical Colleges (AAMC) indicate that the US may be on the possibility of facing a shortfall of somewhere between 21,000 and 55,000 primary care doctors/physicians by the year 2023. Furthermore, with the spikes in demand from the Covid-19 pandemic and any future pandemics, this challenge is far too great to overcome. There is a reason to have fear in such conditions because there is uncertainty regarding whether all of the people living in America would have access to any primary care doctors. This potential shortage of doctors in US that has been pointed out can have various reasons behind it. One could be to highlight the aging of current doctors or an increasingly sick population, or due to the fact that many doctors are reducing their working hours as a cause of burn out or because they’re near to their retirement age.

Doctors/physicians play an important role in the healthcare delivery system. Knowing that the US population is aging, there is population growth and a greater population that’s insured following the Affordable Care Act (ACA). Due to these reasons, healthcare demand is growing at an unprecedented rate. The following article examines the future physician shortage in US trend across the nation, starting from 2017 to 2030.

Shortage of Doctors

Shortage of doctors: A recent study by AAMC, projects a shortage of doctors in US of up to 1,39,000 doctors by 2033, the reasons being: retiring doctors and older patients. After these projections were completed, the pandemic worsened the situation, magnifying the shortage of primary care physicians and specialists.

According to the Association of American Medical Colleges (AAMC), the US will witness a shortage of doctors in US of somewhere between 46,900 to 1,21,900 doctors by 2032 in primary & specialty care. As spoken by Atul Grover in his statement, who is the association’s executive vice president, “We know older patients use 2-3 times as many medical services as younger patients, and also the number of people over the age of 65 will increase by almost 50%, just in the next 10 to 15 years alone.” He explains, “We need positions across the board in just about every specialty and location, but about half of those physicians needed will be in primary care.”

Doctors are required more urgently and in more numbers in some states/localities over others. For example, states such as Arizona are known to be facing a shortage of primary care physicians in all counties. This issue is even worse in rural regions meeting not even half the primary care needs because of lack of primary care physicians. In particular, there is a physician shortage in US in primary care. An 81-page report from the University of Arizona estimates that somewhere between 21,400 and 55,200 primary care doctors will be required even with new primary care models multiplying in number, and with more Americans receiving outpatient care from other health professionals, nurse practitioners, and physician assistants. Physicians such as family practitioners, pediatricians, or internists will be highly in demand. This will be because of the new trends in insurance payment focused on the population’s health and value-based care to make sure that patients get more care upfront, in a primary care doctor’s office or any other outpatient setting such as an urgent care facility/clinic.

Why is there a Shortage of Doctors?

Why is there a shortage of doctors? The following are a number of factors that contribute to the physician shortage in US:

1. The shift in the physician as well as a patient population: Two of the main generational factors that have led to the shortage of doctors in US are:

  1. First, the mass exodus of the doctors: Around 55% of all registered nurses are over the age of 50 years or older. Also, 52% of the doctor workforce which is active, are 55 years old or even more, who are en route to their retirement.
  2. Second, large & aging patient population: An aging baby boomer population (which is currently the largest living generation in the US) is encountering more complex medical conditions today than they ever did. This includes when they were younger, had medical conditions such as arthritis, high blood pressure, diabetes, or even cancer.

Also, the fact that there are a number of specialty areas of doctors that’ll face the brunt of this shortage, such as family practitioners, psychiatry, internal medicine, OB/GYNs (who are already facing lack of primary care physicians), and so forth, will continue to feel the greatest consequences of an aging nation.

2. Having shortages at rural hospitals

Shortage of doctors in US: With millennials entering into the healthcare market, and boomers departing, rural hospitals will also be facing major physician shortage in US. It isn’t as easy to convince a younger practicing doctor to shift to a region that has fewer other young professionals or limited opportunities. While we have CMS creating financial incentives for doctors in rural settings, many of the millennial doctors still prefer to be at work or grow their career paths near or in major cities, surrounded by a population of their peers and dear ones.

3. Limitations on medical schools and residency programs

Doctors who qualify to practice medicine are largely controlled by US medical school enrollment caps and the number of residency slots available in hospitals to train these doctors.

  • Medical school enrollment caps: Without a guess, one can be sure that acceptance rates into medical schools are known to be a bare minimum. As per the AAMC, schools are known to have increased their enrollments by around 30% since the year 2002. Although, this still means that acceptance rates are low. A few selective medical schools like Harvard University only accept about 3.8% of applicants, while an average medical school’s acceptance rates are at around 7%.

4. Churn and burnout

Why is there a shortage of doctors? With a shortage of doctors, providers seek quality engagements with opportunities for growth and exposure to complex cases. Along with manageable workloads, being close to the desired address/location, and having competitive benefits. With the increasing number of outpatient facilities such as urgent care centers, retail clinics, surgery centers, and community health centers, hospitals are fighting to recruit and retain their doctors.

At present, there are two great concerns regarding practicing physicians and medical students entering their workforce – (1) compensation, and (2) a strong work-life balance. The shortage of doctors has left facilities understaffed, which may lead to a doctor’s burnout and cognitive overload. Doctors can avoid joining, or staying at a hospital/facility with unmanageable workloads. This can consist of high volumes of daily procedures and patients. Or the strain of documenting and charting into EHR/EMR systems, which is even worse.

Shortage of Primary Care Physicians

Why is there a shortage of doctors? Shortage of primary care physicians: Why do a growing number of patients deal with the lack of primary care physicians? Here are some contributing factors as to why:

  1. Uneven distribution of S&D – A few of the states/regions face uneven supply and demand of doctors/physicians. For example, not enough PCPs practice in rural regions or impoverished areas.
  2. Incomplete coverage – Uninsured rate is now rising to 13% to 14% of the total population, which is a significant number of people who can’t even afford access to primary care.
  3. Inconvenient hours – In most cases, primary care still isn’t available during so-called inconvenient hours (evenings, nights, or weekends).
  4. Inflexible care models – Most of the markets, even today, rely on PCPs to deliver primary care in a physician’s office. This happens, even after the assistants to doctors and nurse practitioners are capable of delivering primary care at a lower cost and the same high quality.
  5. Payer aversion – Few medical practices can limit the volume of new patients that doctors are willing to take from public programs because these patients are assumingly “unprofitable.”
  6. Ineffective use of doctor labor – Taking estimates of a doctor’s productivity shows 20-30% of a doctor’s available capacity used by clinical documentation, electronic medical record (EMR) inputs, and other work-related to compliance.

Lack of Primary Care Physicians

Lack of Primary Care Physicians: The adequate availability of doctors can determine improvement in the quality of care, increase access to care, and lower healthcare costs. Due to reasons discussed previously, the doctor’s availability to patients has become the top barrier to fulfill the medical needs of a patient in the US. The Bureau of Labor Statistics (BLS) has predicted that over 91,400 physician jobs will be required nationally, which is an increase of 13% from 2016 to 2026. Although, as per predictions, there will be a definite shortage of doctors/physicians in the upcoming decade with the demand for doctors growing faster than the supply. The 2011 report by the Health Resources and Services Administration’s (HRSA) states an estimated deficiency of 17,722 primary care doctors in the US. Moreover, in 2020, the US may face shortages of around 45,400 physicians and 46,100 medical specialists, which amounts to a total of 91,500 doctors in 2020. The most optimistic demand and supply scenario can ensure that the nation would have an adequate supply to meet the demands this year, in 2020.

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Content for MD: Shortage of doctors in US? What’s the cause and what do the studies suggest? Reports suggest shortages in physicians by 2030, reasons include an aging population.

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