New projections pointed to a significant shortage of physicians in the next 10 to 15 years, albeit one smaller than previously anticipated, according to a from the Association of American Medical Colleges (AAMC).
Physician demand is slated to continue to grow faster than supply, leading to a projected shortage of 13,500 to 86,000 physicians by 2036, the report stated.
The shift is due to factoring in scenarios that consider what may happen if graduate medical education capacity continues to grow through funding increases from health systems, states, and the federal government. Specifically, "if continued investment in training new physicians is realized, then the projected gap or shortage of physicians needed to meet the healthcare demands of our country will be mitigated relative to earlier projections," the report stated.
"But if this continued investment fails to materialize," it continued, "then projected shortfalls will be larger than presented here -- closely resembling those presented in the , which projected a shortfall of up to 124,000 physicians by 2034."
As for specific physician categories, primary care is likely to see a heavy hit, with a projected shortage of 20,200 to 40,400 physicians by 2036. (Earlier this month, the National Resident Matching Program also noted ongoing concern regarding the nation's shortage of primary care physicians as it released this year's Match results.)
For surgical specialties, the projected shortage is 10,100 to 19,900 physicians, and for medical specialties, projections range from a shortage of 5,500 to a surplus of 3,700 physicians (for example, if surpluses arise in specialties like critical care, pulmonology, and endocrinology).
For other specialties, projections range from a shortage of 19,500 to a surplus of 4,300 physicians (i.e., if there are surpluses in emergency medicine and other areas like physical medicine and rehabilitation).
Overall, increasing demand for physicians has been primarily driven by demographics -- specifically, population growth and aging. For instance, the population of individuals who are 65 and older is projected to grow by 34.1%, largely due to a 54.7% growth in the population ages 75 and older.
At the same time, with a substantial proportion of the physician workforce nearing the traditional retirement age of 65, "it is very likely that more than a third of currently active physicians will retire within the next decade," the report stated.
Notably, if underserved populations were to have healthcare use patterns similar to populations with fewer access barriers, demand would rise, such that the U.S. would be short by about 117,100 to 202,800 physicians relative to the current supply.
Additional data and research may help to improve healthcare workforce projections, according to the report.
Areas ripe for study include the impacts of COVID-19, such as burnout and early workforce exit, changes in demand due to delayed care, increased use of telehealth, and workforce policies needed to prepare for future pandemics.
There is also a need to collect better data and conduct more research on physician workforce diversity, and to "better elucidate the anti-racist policies that can combat the endemic structural racism that harms our current physician workforce, damages our ability to create a more diverse and inclusive physician workforce, and impedes a diverse population from receiving equitable healthcare," the report noted.
Furthermore, it is important to understand the potential implications of "continued rapid growth" in the advanced practice registered nurse (APRN) and physician assistant (PA) supply. Questions include how the healthcare system will continue to deploy a growing supply of these professionals, as well as to what extent APRNs and PAs have reduced demand for physicians in some specialties, and to what extent they are providing previously unfilled services and expanding access to care.
Further research is also needed to improve the measurement of current shortages across all specialties, to explore why surgeon supply numbers are stagnant, and to understand why physicians of different specialties are practicing in the geographic locations that they are.