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Physician shortage in the United States

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Some healthcare policy analysts and researchers say there is a shortage of physicians in the United States. A shortage of a good or service occurs when demand exceeds supply. When a shortage occurs, consumers typically must wait longer to access the good or service. In healthcare, a physician shortage would mean longer wait times for appointments and procedures.

Concerns over a physician shortage emerged in the early 2000s with the release of multiple state and national assessments of the physician workforce. The concerns have mainly centered on the supply of primary care physicians. However, not everyone agrees on the nature and extent of the problem.[1][2]

HIGHLIGHTS
  • Those who believe there is a nationwide physician shortage say there are increasing demands on the healthcare system and a limited supply of doctors, a situation that will worsen in the future.
  • Some say that worries over a physician shortage are unfounded or that the shortage is confined to certain geographic areas, such as rural communities.
  • The federal government routinely attempts to identify areas with a shortage of physicians; in June 2016, it found that 41.7 percent of the country was underserved in primary care.

    • Debate

    The assertion that there is a general nationwide physician shortage is somewhat contentious in the healthcare community. Additionally, some assert that there is an overall shortage of physicians, while some contend the shortage is confined to primary care physicians. Those who say that there is a current and worsening shortage point to a 2016 report from the Association of American Medical Colleges (AAMC), an organization that represents medical schools and teaching hospitals. The report stated that by 2025, the United States would see a shortage of between 61,700 and 94,700 physicians overall, with a shortage of between 14,900 and 35,600 physicians in primary care. The report used simulation models based on several supply and demand scenarios to develop projections of the physician workforce. From the simulations, the report found that demand for physician services would continue to exceed the number of physicians available.[3]

    Those who believe there is a physician shortage typically posit the following reasons for the described shortage:[4][5]
    General shortage

    • The United States population is aging and growing, placing increasing demands on the healthcare system.
    • The Affordable Care Act brought millions of newly insured patients into the system.
    • Physicians, and in particular primary care physicians, are increasingly vulnerable to burnout, which is physical or mental exhaustion due to overwork or stress.
    • The number of federally funded residency programs has been capped since 1997.

    Primary care shortage

    • Fewer medical students are choosing to practice primary care.
    • Primary care physicians earn lower salaries than specialists.

    Others say that the concerns over physician shortages are undue or exaggerated. They point to a report by a panel from the Institute of Medicine that found no evidence of an overall physician shortage, only an uneven distribution of physicians between certain geographic areas. Still others say that a shortage will not be an issue in the future due to changes in the way medical services are delivered to patients, improvements in efficiency, and increased responsibilities of support staff such as nurse practitioners. Additionally, in an article by Kaiser Health News, Princeton health economist Uwe Reinhardt voiced skepticism of the AAMC report, pointing to its "self-interest in saying there's a shortage, to move more money towards the medical schools and hospitals it represents."[6][7][8]

    Designated shortage areas

    The U.S. Department of Health and Human Services (HHS) attempts to identify areas with physician shortages, called health professional shortage areas (HPSAs). How the boundaries of areas are determined is unclear, but an area can be a geographic area, a population group, or a specific facility. The department generally considers an area to have a shortage if it has one physician for every 3,500 or more people, or one physician for every 3,000 or more people in communities with greater need.[9]

    According to HHS, only 58.3 percent of the need for primary physicians was being met as of June 2016, and 8,514 more primary care physicians were needed across the United States. Connecticut had the smallest percentage of need met at 12.5 percent; at the other end of the spectrum, 93.8 percent of need was met in Delaware. This means that 87.5 percent of Connecticut was underserved in primary care, while only 6.2 percent of Delaware was underserved.[10]

    The table below displays the number of designated primary care shortage areas in each state, along with the percentage of healthcare need met and the number of practitioners needed to have the HPSA designations removed. The first two columns have no bearing on the calculations of physician shortage areas and are only included for informational purposes.

    Primary care health professional shortage areas, 2016
    State Total population (2014) Total primary care physicians Total HPSA designations Population of designated HPSAs Percent of need met Practitioners needed
    Alabama 4,768,000 5,364 80 1,767,665 74.56% 149
    Alaska 695,700 939 82 122,171 34.94% 22
    Arizona 6,657,200 7,862 160 2,781,233 52.09% 417
    Arkansas 2,896,000 3,200 82 426,422 63.54% 52
    California 38,701,300 49,051 578 6,457,834 62.16% 815
    Colorado 5,377,400 6,676 122 949,177 53.26% 148
    Connecticut 3,577,900 6,228 39 403,248 12.50% 121
    Delaware 929,500 1,364 9 203,525 93.84% 4
    District of Columbia 656,900 2,778 15 241,638 50.40% 43
    Florida 19,731,100 24,680 252 4,931,492 40.60% 999
    Georgia 9,965,100 11,366 201 2,095,484 57.01% 296
    Hawaii 1,365,400 1,789 24 71,945 61.58% 7
    Idaho 1,610,200 1,491 99 488,233 63.28% 55
    Illinois 12,797,900 19,878 229 3,438,390 59.92% 438
    Indiana 6,477,500 7,637 120 1,864,269 73.84% 151
    Iowa 3,080,800 3,952 122 637,446 63.92% 74
    Kansas 2,853,000 3,735 159 652,256 67.76% 59
    Kentucky 4,315,700 5,033 152 1,033,198 69.99% 101
    Louisiana 4,556,500 5,661 124 1,939,843 77.82% 143
    Maine 1,299,600 2,212 67 87,588 48.62% 15
    Maryland 5,938,900 10,050 50 981,412 54.89% 169
    Massachusetts 6,658,100 14,214 69 501,019 60.35% 71
    Michigan 9,906,400 16,630 323 1,881,121 64.84% 215
    Minnesota 5,418,500 7,992 120 399,607 52.54% 63
    Mississippi 2,965,300 2,949 109 1,677,481 59.21% 228
    Missouri 5,961,300 8,490 215 1,662,786 30.16% 357
    Montana 1,009,100 1,064 110 257,804 53.62% 37
    Nebraska 1,881,000 2,420 109 28,985 41.79% 5
    Nevada 2,823,400 2,790 74 504,823 51.57% 81
    New Hampshire 1,319,700 1,881 27 58,594 48.40% 9
    New Jersey 8,939,300 13,414 30 28,823 54.90% 13
    New Mexico 2,035,200 2,649 100 867,274 41.56% 162
    New York 19,679,400 36,055 179 3,325,588 43.46% 608
    North Carolina 9,835,800 12,009 140 1,321,426 50.52% 212
    North Dakota 733,400 994 77 179,803 36.66% 30
    Ohio 11,535,600 17,569 137 1,287,330 67.89% 142
    Oklahoma 3,741,700 4,361 177 1,128,756 60.52% 151
    Oregon 3,962,300 5,421 113 920,057 55.76% 137
    Pennsylvania 12,627,100 21,489 159 636,136 63.70% 88
    Rhode Island 1,048,200 2,175 15 152,771 32.75% 37
    South Carolina 4,764,300 5,775 96 1,586,313 70.46% 158
    South Dakota 846,800 966 86 194,924 44.29% 31
    Tennessee 6,502,000 8,323 119 1,279,451 72.30% 114
    Texas 26,687,400 28,021 396 5,248,867 68.14% 525
    Utah 2,929,400 2,731 57 535,396 66.83% 59
    Vermont 617000 1040 30 N/A N/A N/A
    Virginia 8,258,800 10,600 101 1,192,900 69.38% 114
    Washington 7,085,000 9,761 155 1,291,662 45.42% 231
    West Virginia 1,825,500 2,595 107 311,486 69.65% 30
    Wisconsin 5,747,200 7,665 125 812,726 70.11% 77
    Wyoming 572,000 593 39 145,580 69.76% 11
    United States 316,167,900 433,582 6,413 62,351,725 58.28% 8,514
    Sources: The Henry J. Kaiser Family Foundation, "State Health Facts"
    Health Resources and Services Administration, "Designated Health Professional Shortage Areas - Statistics" (Click on "Shortage Areas, Health Professional Shortage Area (HPSA) - Basic Primary Medical Care" and "Designated HPSA Statistics" to access this report.)

    Recent news

    The link below is to the most recent stories in a Google news search for the terms Physician shortage. These results are automatically generated from Google. Ballotpedia does not curate or endorse these articles.

    Physician shortage in the United States - Google News

    See also

    External links

    Footnotes

    1. ↑ Association of American Medical Colleges, "Recent Studies and Reports on Physician Shortages in the US," accessed June 1, 2016
    2. ↑ Annals of Family Medicine, "Projecting US Primary Care Physician Workforce Needs: 2010-2025," accessed June 1, 2016
    3. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named aamcshortage
    4. ↑ The New York Times, "Where Have All the Primary Care Doctors Gone?" December 20, 2012
    5. ↑ KevinMD.com, "Why is there a shortage of primary care physicians?" February 17, 2014
    6. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named iomshortage
    7. ↑ National Institutes of Health, "Is the Physician Shortage Real? Implications for the Recommendations of the Institute of Medicine Committee on the Governance and Financing of Graduate Medical Education," accessed June 1, 2016
    8. ↑ PBS, "Is the U.S. really facing a serious doctor shortage?" November 24, 2014
    9. ↑ The Henry J. Kaiser Family Foundation, "Primary Care Health Professional Shortage Areas (HPSAs)," accessed June 1, 2016
    10. ↑ Health Resources and Services Administration, "Designated Health Professional Shortage Areas - Statistics," accessed June 7, 2016 (Click on "Shortage Areas, Health Professional Shortage Area (HPSA) - Basic Primary Medical Care" and "Designated HPSA Statistics" to access this report.)
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