America faces a significant physician shortage by 2025, according to a physician workforce projection report(www.aamc.org) released by the Association of American Medical Colleges (AAMC) today titled The Complexities of Physician Supply and Demand: Projections from 2013 to 2025.
According to an AAMC press release,(www.aamc.org) the United States could be short between 46,000 and 90,000 physicians overall by that time.
The analysis, compiled for the AAMC by IHS Inc., a global information company headquartered in Englewood, Colo., estimates a primary care shortage of 12,500 to 31,100 primary care physicians and a shortfall of 28,200 to 63,700 nonprimary care physicians, "most notably among surgical specialists.
"The doctor shortage is real -- it's significant -- and it's particularly serious for the kind of medical care that our aging population is going to need," AAMC President and CEO Darrell Kirch, M.D., said in the release.
He pointed out that it takes five to 10 years to train a physician and urged immediate action to forestall "serious physician shortages" by the end of the next decade.
"The solution requires a multi-pronged approach," said Kirch. That approach includes "continuing to innovate and be more efficient in the way care is delivered as well as increased federal support for graduate medical education to train at least 3,000 more doctors a year to meet the health care needs of our nation's growing and aging population," he said.
- The Association of American Medical Colleges released a physician workforce projection report that estimates an overall U.S. physician shortfall of up to 90,000 physicians by 2025.
- Workforce analysis authors predicted a shortage of primary care physicians ranging from 12,500 to 31,100 by 2025.
- The AAMC called for an additional 3,000 residency slots each year from 2015 to 2025; the estimated cost of the additional training positions for the next decade is about $10 billion.
The AAFP praised the AAMC for its dedication to keeping the nation's physician shortage in the spotlight as well its solution-based approach to ensuring that Americans' health care needs are addressed.
"Today’s AAMC workforce projections are a valuable contribution to the discussion about how we're going to meet the demand for care from a population that is both growing and aging," AAFP President Robert Wergin, M.D., of Milford, Neb., said in a statement released by the AAFP.
"It highlights the national need for a comprehensive physician workforce plan that ensures Americans have access to the right care at the right time from the right health professional," he added.
Wergin pointed to a health care delivery system increasingly focused on wellness, prevention and positive results, and declared that such a model "demands a more robust primary care physician workforce."
"Unfortunately, the percentage of our current physician workforce practicing in a primary care specialty is at an all-time low," said Wergin, who suggested that AAMC projections for primary care shortages were low.
"Regardless of the exact numbers, growth in the physician workforce must emphasize growth in primary care while also focusing on other physician specialties such as general surgery and psychiatry," he added.
Addressing Media Questions
Kirch opened an AAMC national media call on March 3 by highlighting the uniqueness of the new report when compared to the many workforce studies compiled in the past. "In many ways, this (report) includes some of the most important variables," said Kirch.
AAMC Chief Health Care Officer Janis Orlowski, M.D., joined Kirch in hosting the call. She said the report modeled a wide range of health care delivery and payment scenarios including bundled payment, the patient-centered medical home model and accountable care organizations, and alternate delivery settings such as retail health clinics.
On the supply side, "We specifically looked at the increase in the integration of advance practice nurses. We looked at physician retirement and physician work hours for the new generation. That is how we came up with the different scenarios," said Orlowski.
"The physician shortage persists under every likely scenario," she added.
When one reporter asked about the cost associated with the AAMC's call for an additional 3,000 residency positions offered each year -- an increase from the current 29,000 to 32,000 -- Orlowski estimated a total cost of $1 billion per year from 2015 to 2025.
Additionally, the AAMC noted in a follow-up email that the average direct cost per resident is about $152,000, of which Medicare pays about $40,000.
Kirch pointed out that medical students would be hard pressed to contribute to their residency costs considering that they typically graduate with an average student debt of about $180,000.
"We really feel strongly that this is a public policy issue that puts the nation's health at risk. The onus is on Congress to lift the artificial cap (on residency positions) that has been in place since the late '90s," said Kirch.
Asked whether the country was facing a maldistribution of physicians rather than a physician shortage, Orlowski responded that the AAMC encouraged states and local communities to focus on the maldistribution problems that affected their populations.
But she added: "You're not going to solve the maldistribution without solving the overall shortage issue."
AAFP Calls for Community-based Training
In his statement, Wergin applauded medical schools for producing well-trained physicians but noted the critical need for additional residency training slots.
"Among the most promising approaches to building the primary care physician workforce is community-based residency training that is funded directly rather than through tertiary, academic health center hospitals," said Wergin.
He noted that community-based programs served two purposes: they attract students interested in medicine and address the maldistribution of physicians.
"Research has demonstrated that a significant percentage of physicians practice within 50 miles of their residency training programs," said Wergin. "These data, together with workforce projections that point to the need for more primary care physicians, will be instrumental in developing a plan that increases the number of both primary care physicians and their subspecialty colleagues,” he added.
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