We’ve all heard that serious physician shortages will be changing the face of healthcare in the next few years. In the 2017 update to “The Complexities of Physician Supply and Demand: Projections from 2015 to 2030,” the Association of American Medical Colleges (AAMC) projected that the total physician shortfall will be between 40,800 and 104,900 physicians by 2030.
But critics of these projections have been arguing for years now that a lack of physicians isn’t the real problem. It’s that the physicians who are practicing now and who will be in the future are poorly distributed. They say too many physicians cluster in urban and affluent areas, leaving rural and poor areas underserved.
So what’s the answer? While it’s always a challenge to look into the future and try to predict or correct problems that haven’t happened yet, there are a few observations we can make.
The Geographic Distribution Problem
It’s not really surprising that physicians tend to work in more affluent and populated areas. They graduate with huge med school debts and need a way to pay those off. Even doctors who would like to work in rural areas often feel they need to work where there’s a higher concentration of affluent patients just so they can make ends meet.
Also, rural areas are less densely populated. A doctor-to-patient ratio that might work perfectly in an urban area often means long travel times for patients and/or doctors in a rural area. Rural areas often need more doctors for a given number of patients simply because of there being such a large geographic area to cover.
Two Problems Or One?
However, poor geographic distribution doesn’t account for everything having to do with projected physician shortages. In fact, the AAMC projections do talk about “geographic imbalances” in physician supply. They just don’t see it as the reason for physician shortages.
Rather, the AAMC views poor distribution of physicians as a separate problem. And they suggest that the increasing shortage of physicians will just make the geographic distribution problems worse. The question isn’t whether physician shortages or poor distribution is the problem. They’re two different, though connected, issues.
Understanding Physician Shortage Projections
When the AAMC makes projections about physician shortages, the key things they’re noticing is that there’s an increasing demand for healthcare services without a corresponding growth in physician supply. In other words, more and more people need health care and there aren’t enough new physicians to keep up with the demand.
There are other factors in play as well. It’s not just the patient population that’s growing older. More and more doctors are retiring as well, which means many physicians currently practicing won’t be working by 2030. Plus, the goal of making healthcare widely available to populations that are currently under-served ups the demand for more physicians.
So What’s Next?
It’s still hard to tell exactly how physician shortages and poor geographic distribution of physicians will play-out in the long-term. Changing regulations and new medical technologies (such as telehealth) are going to affect the physician supply problem. In addition, we’re seeing an increase in the number of APRNs and PAs. It’s not yet clear how much that will affect the physician supply problem, but it may help.
One thing people agree on is that we need to find a way to not only increase the number of physicians but also encourage them to go into primary care in under-served areas of the country. That may involve reforms that will make medical school more affordable. Other changes might come from efforts to improve physician satisfaction rates and avoid burnout. Whatever happens, RadCoverage will be ready to help connect qualified physicians with good jobs as you navigate the rapidly changing healthcare field.