Predictions of a physician shortage continue to climb and the COVID-19 pandemic will likely have both short and long-term impacts on the physician workforce.
The United States could see an estimated shortage of between 54,100 and 139,000 physicians, including shortfalls in both primary and specialty care, by 2033, according to a report (PDF) from the Association of American Medical Colleges (AAMC).
That's higher than a previously projected shortage range for 2032 of between 46,900 and 121,900 physicians.
The demand for physicians will continue to grow faster than the supply, according to the data published by the AAMC in June.
By 2033, AAMC projects a shortage of primary care physicians of between 21,400 and 55,200 and a shortfall of non-primary care specialties of between 33,700 and 86,700 physicians.
The organization's 2020 update was prepared before the COVID-19 crisis, so the report does not include any specific information or scenarios based on that crisis.
"This annual analysis continues to show that our country will face a significant shortage of physicians in the coming years,” said AAMC President and CEO David Skorton, M.D. in a statement. “The gap between the country’s increasing health care demands and the supply of doctors to adequately respond has become more evident as we continue to combat the COVID-19 pandemic. The challenge of having enough doctors to serve our communities will get even worse as the nation’s population continues to grow and age.”
Among the key findings in the report, AAMC found that demographics—specifically, population growth and aging—continue to be the primary driver of increasing demand from 2018 to 2033, according to AAMC. During this period, the U.S. population is projected to grow by 10.4%, from about 327 million to 361 million. The population under age 18 is projected to grow by only by about 4%, which portends low growth in demand for pediatric specialties, while the population aged 65 and over is projected to grow by 45%, which portends high growth in demand for physician specialties that predominantly care for older Americans, AAMC reported.
At the same time, a large portion of the physician workforce is nearing traditional retirement age, and supply projections are sensitive to workforce decisions of older physicians.
More than two of five currently active physicians will be 65 or older within the next decade. Shifts in retirement patterns over that time could have large implications for physician supply. Growing concerns about physician burnout suggest physicians will be more likely to accelerate than delay retirement, according to AAMC's report.
On the other hand, economic uncertainty and any detrimental effect on physician wealth could contribute to delaying retirement.
Meeting the healthcare needs of underserved populations could also impact the physician shortfall. To bring rates of care for currently underserved populations up to the rates for populations facing fewer sociodemographic, economic, and geographic barriers to care, 74,100 to 145,500 more physicians would be needed, according to the report.
Improved access to care is a national goal yet the current physician workforce may not be adequate to achieve these national goals, AAMC said.
The AAMC said it supports passing legislation that would increase federal support for an additional 3,000 new residency positions each year over the next five years.
“As our health care system continues to treat patients during the COVID-19 pandemic, the need for a strong and sufficient health care workforce is more apparent than ever. Specialty physician shortages, especially those that are hospital-based, including critical care, emergency medicine, and pulmonary specialists, are particularly urgent,” Skorton said, noting that hospitals in hard-hit areas have had to rely on a patchwork of solutions, including expanding the scope of practice laws, graduating students early from medical schools, hiring physicians out of retirement, and relocating physicians from other geographic regions to staff their inpatient units.
Although prepared prior to COVID-19, AAMC's report does include some lessons learned from the pandemic and critical shortages of health workers.
The COVID-19 pandemic is likely to have short-and long-term consequences on the nation’s physician workforce, including educational pipeline issues due to the interruption of education, cancellation of clinical rotations, and changes in curriculum as well as regulatory issues, such as changes in licensure and reimbursement, AAMC reported.
The pandemic also will have a long-term impact on how medicine is practiced based on the uptake of telehealth and small private practices being hit hard economically, AAMC said. Workforce exits due to death from COVID-19 or early burnout-induced retirement or postponed retirement due to the economy also will factor into the physician workforce shortage going forward.
AAMC also predicts that the pandemic will impact future physicians' interest in going into certain medical fields. For example, interest in some specialties, like infectious diseases, may increase while interest in others, like emergency medicine, may decrease.