What Doctor Shortage?

You've heard the grim prognosis many times before. Unless immediate action is taken, the U.S. supply of doctors will be 91,500 short of the number needed by 2020 and 130,600 physicians short by 2025, according to an Association of American Medical Colleges estimate. 

Dr. Atul Grover, chief public policy officer at the AAMC, projects that the U.S. needs to train an additional 4,000 doctors a year to avoid a shortage, given the Obamacare insurance expansion, an aging physician workforce, shorter hours worked by younger physicians, and an aging population.

But while some physician and hospital organizations wait for the federal government to pump more money into graduate medical education programs to train additional doctors, other health systems and businesses are using the physician shortage as an opportunity to roll out more cost-effective delivery systems and deploy different types of professionals to provide healthcare.

These innovative organizations are figuring what work needs to be done by a doctor and what work can better be done by different types of providers. They are optimizing the use of different professionals in patient-centered medical homes,accountable care organizations and retail clinics, which may well reduce the number of physicians needed. Some of these changes have been tenaciously opposed by organized medicine, but many physician leaders are embracing the new models.

The physician-shortage crisis is based on assumptions that “could be far from the mark … if the production function for primary care can, indeed, be changed,” wrote Dr. Thomas Bodenheimer, adjunct professor at the University of California at San Francisco, and Dr. Mark Smith, president and CEO of the California HealthCare Foundation, in the November issue of Health Affairs, which focused on physician workforce issues. They said the shortage issue could be solved through technology and reallocation of responsibilities.