The United States will face a significant shortage of physicians fueled by population growth, an increase in the number of aging Americans, and retirement of practicing doctors.
The United States will face a shortage of between 40,800 and 104,900 physicians by 2030, according to a new study commissioned by the AAMC. Released March 14, 2017, the study found that the numbers of new primary care physicians and other medical specialists are not keeping pace with the demands of a growing and aging population.
“There is going to be a significant workforce shortage under all of the likely projections. We see that, quite frankly, only getting worse as the population ages,” said Janis M. Orlowski, MD, AAMC chief health care officer.
The report’s findings are consistent with AAMC estimates from 2015 and 2016. This year’s analysis, conducted by the global information company IHS Markit, extended the date of the projections by five years, from 2025 to 2030, to account for the time needed to fully train a physician who would start medical school in 2017.
For primary care, the estimated shortage will be between 8,700 and 43,100 physicians by 2030. Non-primary care specialties—including medical specialties, surgical specialties, and other specialties—are expected to experience a shortfall of between 33,500 and 61,800 physicians. In particular, the supply of surgeons is projected to have little growth by 2030, but projected demand is expected to increase, resulting in a shortage of between 19,800 and 29,000 surgeons by 2030. For other specialties—emergency medicine, anesthesiology, radiology, neurology, and psychiatry, among others—the projected shortage is between 18,600 and 31,800 physicians by 2030.
The primary factors driving demand are population growth and an increase in the number of older Americans, according to the study. The total U.S. population is expected to grow by about 12% by 2030. Also by 2030, the number of U.S. residents aged 65 and older is expected to increase by 55%, and the number of people aged 75 and older will grow by 73% during the same period.
“This makes the projected shortage especially troubling, since as patients get older they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe,” said AAMC CEO and President Darrell G. Kirch, MD.
For all specialties, retirement decisions of practicing doctors will have the greatest effect on future physician supply, the report notes. More than one-third of all active physicians will be 65 or older in the next 10 years.
Factors affecting projections
For the second consecutive year, the 2017 report includes a special analysis of the needs and health care utilization of underserved populations. According to these data, if barriers to utilization were removed and all Americans accessed health care at the same levels as insured, non-Hispanic white patients, the United States would have needed up to 96,800 additional doctors in 2015. About three-quarters of those physicians would have been needed in urban areas.
“There is going to be a significant workforce shortage under all of the likely projections. We see that, quite frankly, only getting worse as the population ages.”
Janis M. Orlowski, MD
“With this report, people need to understand that if there were equitable utilization, the workforce needs would be even greater. This is an important issue to remember as we plan for a more equitable future,” Orlowski said.
This year’s study, for the first time, examined how achieving certain population health goals—reducing obesity and diabetes, for example—would affect physician demand. The report concluded that meeting these goals would initially result in a slight decline in physician demand, but an overall increase in demand would occur by 2030 because of increased life expectancy.
“As we work on improving certain chronic diseases, you might think that the need for physicians goes down, but it actually goes up because people live longer,” Orlowski said.
As life expectancy goes up, this scenario would slightly increase demand for some specialists, such as geriatricians. But the need for other specialists—endocrinologists who manage diabetes, for example—likely would go down if fewer people required specialized care for chronic diseases.
Averting the shortage
Multiple approaches will be necessary to address the pending shortage, Orlowski said. The AAMC supports a multipronged solution that includes delivery innovations, team-based care, and better use of technology. But the “biggest solution,” Orlowski said, will be training more physicians.
The AAMC continues to advocate for increased federal support for an additional 3,000 residency positions annually over the next five years. Although medical schools have expanded class sizes, it will be hard to increase the overall number of practicing physicians without greater support for graduate medical education.
“We urge Congress to approve a modest increase in federal support for new doctors,” Kirch said. “Expanded federal support, along with all medical schools and teaching hospitals working to enhance education and improve care delivery, would be a measured approach to solve what could be a dangerous health care crisis.”