The Changing Face of the Physician Shortage

Evidence suggests there is a dire physician shortage in not only the US but the world as a whole. To some, the Affordable Care Act is a piece of legislation that contributed to the increased patient demand and therefore the resulting physician shortage. Yet many of the forecasts of the past are under revision due to promising, untested alternatives about how to solve the physician shortage issue.

As evidence of the changing face of the physician shortage, consider a contrasting report from the Association of American Medical Colleges that, at one point, predicted a shortage of more than 90,000 physicians by 2025. This organization’s most recent report from March 2015 cut that number nearly in half to approximately 46,000. Likewise, the government's Health Resources and Services Administration acted similarly. It initially predicted a physician shortage of 20,400, only to reduce the number to 6,400 after considering the roles of physician assistants and nurse practitioners.

Same Problem, New Solutions

Few people are arguing that a doctor shortage exists. The real debate lies in the question of how severe that shortage is and how it can be resolved best. It comes down to having the same problem, but offering new solutions:

• Better Distribution – The case can be made statistically that the current physician shortage is a distribution problem, not a resource problem. Numerous studies have shown that certain kinds of physicians are heavily concentrated in urban areas while some rural areas are terribly underserved. By distributing doctors more evenly, some of the most severe shortages can be ameliorated.

• Shared Workload – In considering physician assistants and nurse practitioners as shortage relievers, the outlook becomes brighter. More states are giving these professionals greater latitude to set up their practices without doctor supervision. They can pick up some of the slack by handling routine care typically provided by primary care doctors.

• Home-Based Care – We are gradually seeing a shift to more home-based care by way of telemedicine and visiting nurses. A greater concentration on this kind of care encourages patients to stay at home for problems that are not extremely pressing and readily solvable. Treating more patients through telemedicine reduces congestion at the local office or health clinic.

Of these three solutions, perhaps the most intriguing is that of better healthcare delivery distribution. Critics of the physician shortage idea have long maintained that better distribution would virtually eliminate all of the shortages around the country. Whether or not that is true, is a matter of debate. However, the better distribution would certainly ease the burden in underserved areas.

There is indeed a physician shortage in the US, but the public and private sectors suggest the shortage is not as stymied as it was once believed to be. With a little creativity and some new solutions, we could be in a very strong position to improve the physician shortage in the next decade, especially with increasing locum tenens usage rates. In the meantime, funneling more students into medical school as primary care physicians will remain an important objective in weakening the negative impact of the physician shortage.

Sources:

1. AAMC – https://www.aamc.org/download/426242/data/ihsreportdownload.pdf
2. Washington Post – http://www.washingtonpost.com/news/to-your-health/wp/2015/03/05/more-abo...