Current focus on the physician shortage calls for historic perspective on the growth of the physician workforce and a close examination of the capability of our current workforce to meet population needs. Workforce adequacy remains open to debate in light of the relentless, outsized growth of health care and the federal health policy's “triple aim,” which focuses on care, health, and cost.1
We examined the growth rate of the direct patient care physician workforce and its specialty and primary care components using the U.S. Department of Health and Human Services Area Resource File (1980 to 2000), American Medical Association Physician Masterfile (2000 to 2010), and the U.S. Census (1980 to 2010). The data are presented in the accompanying figure. Physician-to-population ratios have steadily increased every decade since 1980. The rate of growth in the physician workforce has decelerated in the past decade, but still outpaces population growth.
However, many segments of the population, especially vulnerable populations, have difficulty accessing physician services, a problem likely to increase amidst insurance reform and a patient aging trend.2 A relative shortage in the physician workforce with geographic and specialty maldistribution contributes to difficulties in accessing needed services.3,4 Simply increasing the number of physicians may not be as effective as focused investment in a specialty and geographic balance that is more accountable to population needs.2,5