The U.S. is going to have a massive shortage of physicians in primary and specialty care by 2034, according to new estimates.
The Association of American Medical Colleges (AAMC) projects a shortage between 37,800 and 124,000 physicians, with the largest disparities being in the area of specialty doctors.
The seventh annual study by the life science division of IHS Markit was conducted in 2019, prior to the start of the COVID-19 pandemic, and looked at data such as physician work hours, retirement and other trends in the healthcare workforce.
"The COVID-19 pandemic has highlighted many of the deepest disparities in health and access to health care services and exposed vulnerabilities in the health care system,” AAMC President and CEO David Skorton, M.D., said in a statement. “The pandemic also has underscored the vital role that physicians and other healthcare providers play in our nation’s healthcare infrastructure and the need to ensure we have enough physicians to meet America’s needs.”
One of the biggest concerns for the future of physicians is the rise in clinician burnout, which—intensified by the pandemic—has led workers to cut hours or accelerate retirement. Before the pandemic, in 2019, 40% of U.S. physicians felt burned out at least once a week. And according to the survey, more than two out of every five active physicians in the U.S. will reach the age of 65 or older within 10 years.
“We are taking a closer look at the well-being of healthcare workers,” Janis Orlowski, M.D., chief healthcare officer for the AAMC, told Fierce Healthcare. “We had a summit right before COVID with CEOs to discuss what we could do nationally to standardize metrics for credentials and licensing to take the burden of paperwork and overhead from physicians.”
Simultaneously, she said the industry needs to make sure teams are working together locally to improve well-being for all healthcare staff, and ultimately, patients.
Shortage or not, factors within the U.S. population are speeding up the need for more healthcare workers. For example, from 2019 to 2031, the population is projected to grow by 10.6%, with an increase of 42.4% of those aged 65 and above.
Looking at the data specifically, primary care shortages will range between 17,800 and 48,000 physicians. And within specialties, surgical shortages will be one of the highest, between 15,800 and 30,200 physicians.
Orlowski notes the number of medical schools and medical education enrollment are up, which is a positive step toward increasing the number of physicians in the U.S.
And at the end of 2020, Congress added 1,000 new Medicare-supported graduate medical education positions—200 per year for five years—targeted at underserved rural and urban communities. New bipartisan legislation called The Doctors of Community (DOC) Act, introduced in the House of Representatives Tuesday and expected to be released in the Senate next week, would permanently authorize the Teaching Health Center Graduate Medical Education program that aims to train primary care medical and dental doctors. The legislation would increase annual funding by more than $500 million per year from 2024 through 2033.
Finally, the pandemic has put a spotlight on disparities in health and access to care among underserved populations in the U.S. The estimates in the survey do not include the additional 180,400 physicians AAMC believes the country would need if there were fewer barriers to access for minority populations as well as if people living in rural communities and people without health insurance were included.
“The issue that I’m probably most worried about is equity,” said Orlowski. “As we take a look at equity throughout the U.S. and how different populations are affected by COVID, it strikingly points out the differences of access and utilization. If everyone had the same access to physicians as those who are living in an urban center, white, not low-income, we would still need more than 180,000 physicians to build equity. And that’s not 15 years from now, that’s today.”