April 18, 2018
It’s no secret that the United States population is aging. In just over a decade, the number of Americans in the 65-and-older age bracket will have mushroomed by 50 percent. Not as widely known is the fact that this aging population is likely to impact physician supply as well, because one-third of all currently practicing physicians will be older than 65 within the next 10 years. Many of these physicians will be choosing to retire, although what proportion will do so is not yet known. Many others will reduce their clinical hours.
These major demographic shifts will have important implications for healthcare providers and the American healthcare system as a whole as it works to meet the complex medical needs of a growing number of older adults who are living longer with multiple chronic conditions. Will there be enough physicians to care for an expanding and aging population?
It appears not. A new report by the American Association of Medical Colleges (AAMC) titled The Complexities of Physician Supply and Demand: Projections from 2016 to 2030 estimates a shortfall of 14,800 to 49,300 primary care physicians, as well as a shortfall of 33,800 to 72,700 physicians across the specialties, by 2030.
The study reflects and updates the key findings regarding trends in physician supply and demand of AAMC studies conducted in 2015, 2016 and 2017. Findings of significant shortages persist “despite modeling that takes into account the use of other health professions and changes in care delivery,” AAMC notes in a statement. (The projected shortfall is higher than last year’s projection of 40,800 to 104,900 physicians overall.)
Physicians nearing retirement age represented a significant proportion of working physicians, with those aged 65 years and older accounting for 13.5 percent of the workforce and those between 55 and 64 years representing 27.2 percent, according to the report.
AAMC President and CEO Darrell G. Kirch, MD, calls the shortage, coupled with the increasing demand for physicians over the next 12 years, a “serious threat” that demands immediate concerted efforts to train more doctors now to meet future needs.
Among the report’s other key findings:
Changing demographics are driving increased demand. Between 2016 and 2030, the U.S. population is expected to increase by nearly 11 percent from 324 million to 359 million. Those under 18 are projected to grow by only three percent, while those aged 65 and older are projected to grow by 50 percent. Because older adults consume more healthcare services than younger populations, “the percentage growth in demand for services used by seniors is projected to be much higher than the percentage growth in demand for pediatric services.”
Population health efforts may increase the long-term demand for physicians. Achieving such population health goals as weight reduction, blood pressure, cholesterol and blood glucose management, and smoking cessation could slightly decrease the demand for physicians. However, the increased life span associated with these health improvements could lead to a growing need for medical services by 2030, raising the demand for physician full-time equivalents (FTEs) by 17,300 compared to what the demand would be if these goals were not reached.
Increased access to healthcare would increase the demand for physicians. Modeling of the impact of effectively removing current barriers to care revealed that demand for physicians could rise substantially. “These estimates . . . help illuminate the magnitude of current barriers to care and provide an additional reference point when gauging workforce adequacy,” according to the report.
The trend among physicians to work fewer hours weekly is contributing to the FTE physician shortage. A decline in the number of weekly work hours among physicians in all age groups between 2002 and 2016 could lead to 32,500 fewer FTE physicians by 2030, if the trend persists.
“Uncertainties continue to abound about whether, how, and how quickly emerging payment and care-delivery models might affect physician supply and demand,” the report adds. “Still, evidence to date has not demonstrated that changes in payment or care-delivery models substantially change physician workforce supply or demand.” The report calls for additional research in such areas as geographic imbalances in provider supply and the impact of new care delivery and financing models, such as telemedicine, on the future need for physicians.