As family medicine residency programs grapple with how to incorporate new duty hour and other limits for physician-trainees, the Association of American Medical Colleges, or AAMC, has released workforce projections that reveal physician shortages will be even worse in the new health care reform environment than previously anticipated.
In a Sept. 30 press release(www.aamc.org), the AAMC announced that it has revised its earlier estimates of current and looming physician shortages; the new figures are more than 50 percent greater than previous estimates. As a result, the AAMC is calling on the U.S. Congress to support at least a 15 percent increase in residency training slots to lessen those shortages and enhance access to care.
Prior to the passage of the Patient Protection and Affordable Care Act, "the United States already was struggling with a critical physician shortage, and the problem will only be exacerbated as 32 million Americans acquire health care coverage and an additional 36 million people enter Medicare" in the next decade, said the AAMC press release.
The updated findings(www.aamc.org) from the AAMC Center for Workforce Studies include the following:
- Between now and 2015, the year after all new health care reform provisions take effect, the shortage of physicians across all specialties will more than quadruple, from 13,700 to 62,900. The shortage in 2015 is more than 58 percent greater than estimates before the passage of health care reform.
- In the next decade, there will be a shortage of more than 45,000 primary care physicians and a shortage of more than 46,000 surgeons and other medical specialists -- a total shortage of more than 91,000 physicians.
- In the next decade, the number of Americans older than age 65 is expected to increase by 36 percent. During the same period, nearly one-third of all physicians are expected to retire.
- Although the physician shortages will affect every segment of the U.S. population, the most severe impact will be on the 20 percent of Americans who live in rural or inner-city locations designated as health professional shortage areas.
- Finally, although the number of medical students will continue to increase -- by as many as 7,000 additional medical school graduates each year during the next decade -- unless Congress acts now to increase the number of residency training slots, "access to health care will be out of reach for many Americans."
"Congress must lift the freeze on Medicare-supported residency positions," the AAMC emphasized. "Because all physicians must complete three or more years of residency training after they receive an M.D. degree, Medicare must continue paying for its share of training costs by supporting at least a 15 percent increase in GME (graduate medical education) positions, allowing teaching hospitals to prepare another 4,000 physicians a year to meet the needs of 2020 and beyond."
The AAFP has made similar calls to Congress, stating in its 2009 workforce reform policy that additional training positions for family physicians need to be funded.
More recently, the AAFP has characterized new Common Program Requirements(acgme-2010standards.org) approved by the Accreditation Council for Graduate Medical Education as placing an added financial burden on many family medicine residency programs -- especially smaller rural programs -- at a time when the need for more primary care physicians has never been greater.