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Physician Shortages

Physician Shortages. Prepared by: Shaheena Patierno, MSIII SUNY Upstate Medical University. Current Forecasts. By the year 2020, there will be a shortage of between 85,000 and 96,000 physicians. Population factors will aggravate this problem over the next 12 years:

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Physician Shortages

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  1. Physician Shortages Prepared by: Shaheena Patierno, MSIII SUNY Upstate Medical University

  2. Current Forecasts • By the year 2020, there will be a shortage of between 85,000 and 96,000 physicians. • Population factors will aggravate this problem over the next 12 years: • U.S. population to grow by 50 million people (18% growth) • Geriatric population to grow from 35 million to 54 million people

  3. Shortage in ER Physicians • Lack of ER Physicians • Lack of board certified and residency trained • 38% of currently practicing ER docs are neither • Workforce Study (2008) • 12 years of constant growth • No attrition • Needed to reach saturation

  4. Shortage in Primary Care Physicians • Currently, 38% of the physician workforce practice primary care medicine • Ideal percentage hypothesized to be 50% by ACGME • Patients turn to ERs when they cannot get access • Fewer U.S. medical school graduates choosing primary care

  5. Factors Causing Shortage in Primary Care Physicians • Disparity in incomes • Lower total reimbursement • Medicare’s reimbursement guidelines are not as favorable to primary care • Other factors • Burden of numerous patients • Business of the practice • On-call obligations are more onerous

  6. Uneven Distribution of Providers • Rural areas have a smaller ratio of doctors to people • Metropolitan ratio of 262 physicians per 100,000 people • Rural areas (<50,000 people) is 92.5 physicians per 100,000 • Areas with less than 10,000, is 72 physicians per 100,000 • 21% of U.S. population lives in rural areas • Only 12% of ER physicians choose to practice there • Uneven distribution primarily due to location of residencies • Most practice where their residency program trained them • Most residency programs are located in urban areas

  7. Possible Solutions • Increase the number of physicians in production annually. • Increase incentives for entering primary care. • Optimize distribution of physicians.

  8. Conclusion • Severe physician workforce shortages • Incentives needed to encourage Emergency Medicine and Primary Care • Better physicians distribution needed

  9. References • Camargo, CA Jr. Ginde AA, Singer AH, Espinola JA, Sullivan AF, Pearson, JF, Singer AJ. Assessment of emergency physician workforce needs in the United States, 2005. Acad Emerg Med. 2008: 15(12): 1317-1320. • Bodenehimer T, Berenson RA, Rudolf P. The primary care-specialty income gap: why it matters. Ann Intern Med. 2007; 146(4): 301-306. • Bureau of Health Professions. Physician supply and demand: projections to 2020. U.S. Department of Health and Human Services, 2006. • Council on Graduate Medical Education. Physician distribution and healthcare challenges in rural and inner-city areas. Tenth Report. U.S. Department of Health and Human Services, 1998. • Council on Graduate Medical Education. Physician workforce policy guidelines for the United States, 2000-2020. Sixteenth Report. U.S. Department of Health and Human Services, 2005. • Ginsburg P, Berenson RA. Revising Medicare’s physician fee schedule- Much activity, little change. New England Journal of Medicine. 356(12):1201-1203. • Institute of Medicine of the National Academies. Future of emergency care series: hospital-based emergency care at the breaking point. Washington, DC: National Academy Press, 2008. • Lasser KE, Woolhandler S, Himmelstein DU. Sources of U.S. physician income: the contribution of government payments to the specialist-generalist income gap. J Gen Intern Med. 2008; 23(9): 1477-1481. • National Advisory Committee on Rural Health and Human Services. The 2008 Report to the Secretary: rural health and human services issues. U.S. Department of Health and Human Services, 2008. • Powers, R. Emergency Department use by adult Medicaid patients after implementation of managed care. Acad Emerg Med. 2000; 7(12):1416-1420.

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