Is it true that we have, or are likely to have in the imminent future, a shortage of medical doctors? For several years now, healthcare industry thought leaders have been telling us that there was a looming physician shortage on the horizon. Anything that changes the number of available physicians or the demand for their services affects the supply and demand balance.
Well it seems to be true, the United States is facing a serious shortage of physicians, largely due to the growth and aging of the population and the impending retirements of older physicians. The number of Americans age 65 or older is expected to almost double over the next 30 years. A report from the American Association of Medical Colleges predicts a shortage of 120,000 physicians by 2030. Because, without adequate physicians, patients may experience long wait times, receive delayed medical attention, and be limited to care from non-physician providers. There will be shortages in both primary and specialty care, and specialty shortages will be particularly large.
According toresearch data, the primary care shortage can be as many as 43,100 by the year 2030, while non-primary care specialties may experience a shortfall of up to 61,000 physicians. Within those numbers, certain specialties, such as emergency medicine, neurology, psychiatry, anesthesiology, and others may experience a shortage of between 18,600 and 31,800 by the year 2030.
With all this being said, a number of solutions, including short-term fixes and long-term solutions, have been proposed to address physician shortages. Here is a list of the most current, public ideas out there right now, some have been tested and applied in national health workforce policies and plans, while others remain subject to ongoing debate.
• Increase the number of medical graduates through increased recruitment of minority students domestically, as well as intensified recruitment of foreign-trained graduates (also known as
• Increase the number of medical schools and classroom sizes.
• To address physician shortages in rural areas, develop, organize, and locate medical schools to increase the propensity of physicians entering rural practice. Accepting medical school applicants from rural areas can also increase the proportion of rural physicians.
• To address physician shortages in high population growth areas in the United States unfreeze the 1996 Graduate Medical Education (GME) freeze/cap instituted by Congress.
• Higher medical school enrollment limits.
• Loosen the requirements for entry to medical school, such as eliminating the need for a pre-med bachelor’s degree as required in some jurisdictions, thereby making the education path more attractive for potential students.
• Reduce the costs for students to attend medical school, such as through subsidies for (free or reduced) school tuition and more financial aid.
• Legislate tuition-increase caps for medical schools.
• Increase the role of the National Health Service Corps, which help provide debt-relief opportunities for primary care physicians.
• Make better use of other categories of health care professionals, including more Osteopathic Physicians (DOs), nurse practitioners, physician assistants, clinical officers, community health workers, and others.
• Improve physician wages, such as through privatization of health care systems thereby enhancing market attractiveness for people to become doctors.
• Improve physicians’ perspectives of their future career path, such as though reduced use of temporary employment contracts
• Provide better incentives for physicians to practice in rural and medically underserved areas – for example, in the U.S., this could include expanding the National Health Service Corps for rural areas.
• Ensure better practice conditions for physicians – for example, medical liability reforms have been cited as an important factor in the U.S.
• Increase the use of e-mail and telephone consultations, which allow physicians to treat patients seeking more traditional forms of care.
• In the United States, to better accommodate the elderly and their demand for healthcare services, increase medical and nursing training in geriatrics and gerontology.
• Increase use of health care or medical teams (i.e. nurse practitioners and physician assistants) to shift physician workload and allow for increased physician times with patients.