Why the Physician Shortage Could be Getting Worse

August 20, 2020 Health Ideas Staff

Alarms of a worsening physician shortage have been sounding for some time. And although the latest data trending toward that end reflects a pre-pandemic scenario, current and ongoing circumstances are far more likely to exacerbate the issue than alleviate it.

2020 report from the Association of American Medical Colleges (AAMC) projects a U.S. physician shortage of 54,100 to 139,000 physicians by 2033. Those numbers are higher than the previous year’s report, which estimated a shortage of up to 122,000 physicians by 2032.

Though released in 2020, the latest AAMC analysis was conducted in 2019 and therefore does not take into consideration the impact of COVID-19 on healthcare supply and demand. There are, however, several insights to be gained from the report’s findings as well measures that could help mitigate a physician shortage, including some that are currently in place to mitigate the effects of the pandemic.

The Supply & Demand Challenge of an Aging Population

According to a U.S. Census Bureau report, for the first time in the U.S., older adults are expected to outnumber children by the year 2035. But as people are living longer, the unfortunate reality is that they are also living sicker. A survey from The Commonwealth Fund found that 36% of older Americans are living with three or more chronic conditions. Factoring in declines in preventive and even urgent care visits amid the COVID-19 pandemic, physicians could soon be dealing with an even more complex host of health issues.

At the same time the patient population is aging, so too are the physicians who treat them. The AAMC reports that two out of five physicians will be 65 or older in the next 10 years, noting that physician burnout concerns could lead many to retire earlier than later.

The Impact of COVID-19 on the Healthcare Workforce

Staffing challenges have been a dire consequence of COVID-19, as healthcare workers fall ill and far too many have tragically died from the disease. Separately, hospitals are struggling financially due in large part to interrupted revenue streams, such as pausing elective procedures, forcing many to lay off or furlough workers.

As New York City, the initial epicenter of the virus in the U.S., faced a shortage of critical care staff, med school students were granted early graduation, doctors came out of retirement and healthcare workers from across the country traveled to the city to assist. And although New York maintains a low case count at the time of writing, new data shows those days are far from behind us in many parts of the country. An August 7, 2020 update from the Mullan Institute State Hospital Workforce at George Washington University found that 26 states are expected to face a shortage of ICU physicians to treat COVID-19 patients, up from just five states the week prior.

Maximizing Capacity Through Technology, Education & Care Coordination

In the immediate term, current disease control measures are key to slowing the spread of the virus in order to maximize hospital capacity and protect frontline healthcare workers. Over the longer term, streamlining care delivery, maximizing the capabilities of trained medical personnel and improving efficiencies across the healthcare workforce and care continuum could help to alleviate a physician shortage. Key areas of focus may include:

  • Continued expansion of telehealth. Though the federal government expanded telehealth services in response to COVID-19, provider shortages and other barriers to care had been an ongoing issue in many parts of the country long before the pandemic hit. Continued adoption of telehealth could help to reduce physician burnout and increase healthcare capacity, particularly for those living in rural areas. On August 3, 2020, the Centers for Medicare and Medicaid Services proposed to permanently expand telehealth benefits for Medicare beneficiaries as part of the Executive Order on Improving Rural and Telehealth Access.
  • Better care coordination. Research has shown that enhanced care coordination efforts — specifically, a more patient-centered, team-based and technology-driven approach — could potentially eliminate primary care physician shortages while improving the quality of care.
  • Use of automation and artificial intelligence toolsAdvisory Board research suggests that artificial intelligence has the potential to drive physician-patient ratios of up to 25,000 patients per primary care physician. Though an admittedly “bullish” estimate, Advisory Board’s data underscores the potential of efficiency-enhancing technology in alleviating administrative burden and streamlining clinical workflows.
  • Addressing shortcomings in physician training. The medical training system in the U.S. has faced scrutiny for being overly complex and costly, with medical school students graduating with $180,000 in debt, on average. As the U.S. Department of Health and Human Services noted in a 2017 report, this heavy burden leads many graduates to pursue higher-paying specialties, rather than primary care roles. With COVID-19 altering college admissions and schedules, it may be an opportune time to reevaluate the training process in order to increase the number of medically trained professionals at a time when they’re needed most.

While the full impact of COVID-19 on the healthcare workforce remains to be seen, it is clear that the crisis is likely to exacerbate a long-coming trend. As the government, states and healthcare organizations take measures to mitigate physician and resource shortages during the current health emergency, perhaps, like telehealth, some of these measures will be here to stay and improve efficiencies in the long term.

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