Physician Shortages

1
Physician Shortages
Prepared by Shaheena Patierno, MSIII SUNY
Upstate Medical University
2
Current Forecasts

• By the year 2020, there will be a shortage of
  between 85,000 and 96,000 physicians.
• Population factors will aggravate this problem
  over the next 12 years
• U.S. population to grow by 50 million people (18
  growth)
• Geriatric population to grow from 35 million to
  54 million people

3
Shortage in ER Physicians

• Lack of ER Physicians
• Lack of board certified and residency trained
• 38 of currently practicing ER docs are neither
• Workforce Study (2008)
• 12 years of constant growth
• No attrition
• Needed to reach saturation

4
Shortage in Primary Care Physicians

• Currently, 38 of the physician workforce
  practice primary care medicine
• Ideal percentage hypothesized to be 50 by ACGME
• Patients turn to ERs when they cannot get access
• Fewer U.S. medical school graduates choosing
  primary care

5
Factors Causing Shortage in Primary Care
Physicians

• Disparity in incomes
• Lower total reimbursement
• Medicares reimbursement guidelines are not as
  favorable to primary care
• Other factors
• Burden of numerous patients
• Business of the practice
• On-call obligations are more onerous

6
Uneven Distribution of Providers

• Rural areas have a smaller ratio of doctors to
  people
• Metropolitan ratio of 262 physicians per 100,000
  people
• Rural areas (lt50,000 people) is 92.5 physicians
  per 100,000
• Areas with less than 10,000, is 72 physicians per
  100,000
• 21 of U.S. population lives in rural areas
• Only 12 of ER physicians choose to practice
  there
• Uneven distribution primarily due to location of
  residencies
• Most practice where their residency program
  trained them
• Most residency programs are located in urban areas

7
Possible Solutions

• Increase the number of physicians in production
  annually.
• Increase incentives for entering primary care.
• Optimize distribution of physicians.

8
Conclusion

• Severe physician workforce shortages
• Incentives needed to encourage Emergency Medicine
  and Primary Care
• Better physicians distribution needed

9
References

• Camargo, CA Jr. Ginde AA, Singer AH, Espinola JA,
  Sullivan AF, Pearson, JF, Singer AJ. Assessment
  of emergency physician workforce needs in the
  United States, 2005. Acad Emerg Med. 2008
  15(12) 1317-1320.
• Bodenehimer T, Berenson RA, Rudolf P. The primary
  care-specialty income gap why it matters. Ann
  Intern Med. 2007 146(4) 301-306.
• Bureau of Health Professions. Physician supply
  and demand projections to 2020. U.S. Department
  of Health and Human Services, 2006.
• Council on Graduate Medical Education. Physician
  distribution and healthcare challenges in rural
  and inner-city areas. Tenth Report. U.S.
  Department of Health and Human Services, 1998.
• Council on Graduate Medical Education. Physician
  workforce policy guidelines for the United
  States, 2000-2020. Sixteenth Report. U.S.
  Department of Health and Human Services, 2005.
• Ginsburg P, Berenson RA. Revising Medicares
  physician fee schedule- Much activity, little
  change. New England Journal of Medicine.
  356(12)1201-1203.
• Institute of Medicine of the National Academies.
  Future of emergency care series hospital-based
  emergency care at the breaking point. Washington,
  DC National Academy Press, 2008.
• Lasser KE, Woolhandler S, Himmelstein DU. Sources
  of U.S. physician income the contribution of
  government payments to the specialist-generalist
  income gap. J Gen Intern Med. 2008 23(9)
  1477-1481.
• National Advisory Committee on Rural Health and
  Human Services. The 2008 Report to the Secretary
  rural health and human services issues. U.S.
  Department of Health and Human Services, 2008.
• Powers, R. Emergency Department use by adult
  Medicaid patients after implementation of managed
  care. Acad Emerg Med. 2000 7(12)1416-1420.