Recruiting physicians is difficult and expensive already. New research suggests that a coming crisis could make recruitment even more challenging.
A study from the Association of American Medical Colleges (AAMC) predicts the United States will be short between 54,100 and 139,000 physicians by 2033. This shortage translates to primary care, where the AAMC expects to see a shortage of 21,000 to 55,200 physicians. According to the report, there would be a shortage of anywhere between 21,400 and 55,200 primary care physicians.
Some states have already taken steps to mitigate the shortage. For example, Idaho’s Joint Finance-Appropriations Committee adopted an aggressive 10-year plan to increase funding for medical residencies in January 2017. In January 2020, the Idaho State Journal reported Idaho has increased from 49th to 47th in the nation for primary care doctors per capita as a result of this program.
What are the leading causes of the physician shortage? What three resources can physicians use to prepare for the increasing workload that will result from the growing physician shortage?
Top Causes of the Shortage
Multiple factors have led to the looming physician shortage. Although the shortage has been building for a while, we may have a chance to reduce its impact by focusing on mitigating the following factors:
- The graying of America. The number of patients age 65 and older is expected to grow by 48 percent between 2017 and 2032. The aging population uses more healthcare resources per capita, thus increasing physician demand.
- The aging workforce. Similarly, about 33 percent of physicians will be 65 or older in the next 10 years and may retire. Although physicians can work well past that age, the average age of retirement is 66.
- Caps on residency programs. Physician residency programs are federally funded and the government has not increased the number of slots in these programs in twenty years. Population growth is therefore outpacing the number of new residents being trained.
- Mounting medical debt. Medical school debt may deter some young medical students from independent practice. The average resident coming out of training has hundreds of thousands of dollars of school debt. As a result, recent graduates often gravitate toward employed positions that offer loan repayment and high starting salaries.
Immediate Effects of the Physician Shortage
Effect on patients: Burnout can result in decreased quality of patient care. With fewer and fewer new physicians replacing burnt-out doctors, the entire primary care system is threatened. The physician shortage already impacts rural areas. Patients in these areas may face greater socioeconomic disparities or not have access to reliable transportation. Some patients are left without a primary care physician or must travel long distances to see one.
Effects on physicians: Seventy-nine percent of primary care physicians report suffering from burnout symptoms, burnout costs the healthcare system $4.6 billion every year. Moreover, more than one-third of physicians say they will not recommend the profession to prospective medical students.
So, What Can Current Physicians Do?
Although practice owners cannot anticipate all of the consequences of the physician shortage on their practices, there are at least five proactive steps primary care physicians can take to meet changes in demand:
- Telehealth, telehealth, telehealth. Aging populations will require more services that they may not be able or want to go to the office to obtain. Telehealth will reduce the no-show and missed-appointment rates and can even reduce physician burnout by allowing for more flexibility in physicians’ schedules.
- Recruit Advanced Practice Providers (APPs) — Nurse Practitioners and Physician Assistants. Hiring APPs such as physician’s assistant (PA) or a nurse practitioner (NP) can maintain or increase a physician’s practice’s capacity and reduce physician burnout. In part because of the physician shortage, the number of NPs and PAs is expected to increase by 47 percent and 38 percent in 2025, respectively.
- Delegate tasks accordingly. Many physician practice owners already employ. individuals who provide administrative support. Medical assistants and nurses and others can provide valuable support to expand capacity and reduce burnout.
- Smaller tech counts, too. In addition to complex technical capabilities such as telehealth, physicians may want to invest in tools such as virtual scribes and coders. Virtual scribes and coders often work in teams in which several virtual scribes become familiar with a particular physician’s workflow, so a scribe is always available if a physician’s usual scribe goes on vacation. Virtual scribes and coders are familiar with common electronic health record (EHR) systems and can help physicians save time so they can see more patients, thereby reducing the impact of the physician shortage.
- Understand the next generation of physicians. Paying attention to the direction in which the new generation sees healthcare can help current physicians develop effective hiring strategies for millennial physicians. Studies show that millennial physicians are more likely to choose open positions that they perceive will give them a great work-life balance, more comfortable with using technology in their medical practices, and prefer mentoring from older physicians. To attract millennial physicians, studies recommend current physicians clearly define their practice’s career opportunities and show why their practice is a good fit for potential candidates.
Finally, if you are a primary care physician who is ready to retire, give yourself up to two years to find a new physician who will be a good fit for your practice and community. Practice your behavioral interviewing skills and aggressively pursue promising candidates. Although the physician shortage is concerning, there are steps primary care physicians can take to minimize its effect on their practice.