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124K More Physicians Will be Needed by 2034, With the Largest Gap Among Specialists

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by Jacqueline Renfrow | 

 January 15, 2025 10:10am

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The estimates in the Association of American Medical Colleges survey do not include the additional 180,400 physicians the association believes the country would need if there were fewer barriers to access for minority populations as well as if people living in rural communities and people without health insurance were included. (Getty/Geber86)

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The U.S. is going to have a massive shortage of physicians in primary and specialty care by 2034, according to new estimates.

The Association of American Medical Colleges (AAMC) projects a shortage between 37,800 and 124,000 physicians, with the largest disparities being in the area of specialty doctors.

The seventh annual study by the life science division of IHS Markit was conducted in 2019, prior to the start of the COVID-19 pandemic, and looked at data such as physician work hours, retirement and other trends in the healthcare workforce.

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"The COVID-19 pandemic has highlighted many of the deepest disparities in health and access to health care services and exposed vulnerabilities in the health care system,” AAMC President and CEO David Skorton, M.D., said in a statement. “The pandemic also has underscored the vital role that physicians and other healthcare providers play in our nation’s healthcare infrastructure and the need to ensure we have enough physicians to meet America’s needs.”

RELATED: Physician shortage: The numbers keep climbing, now estimated at 122,000 by 2032

One of the biggest concerns for the future of physicians is the rise in clinician burnout, which—intensified by the pandemic—has led workers to cut hours or accelerate retirement. Before the pandemic, in 2019, 40% of U.S. physicians felt burned out at least once a week. And according to the survey, more than two out of every five active physicians in the U.S. will reach the age of 65 or older within 10 years.

“We are taking a closer look at the well-being of healthcare workers,” Janis Orlowski, M.D., chief healthcare officer for the AAMC, told Fierce Healthcare. “We had a summit right before COVID with CEOs to discuss what we could do nationally to standardize metrics for credentials and licensing to take the burden of paperwork and overhead from physicians.”

Simultaneously, she said the industry needs to make sure teams are working together locally to improve well-being for all healthcare staff, and ultimately, patients.

Shortage or not, factors within the U.S. population are speeding up the need for more healthcare workers. For example, from 2019 to 2031, the population is projected to grow by 10.6%, with an increase of 42.4% of those aged 65 and above.

RELATED: Physician shortage could hit 130K by 2033, AAMC projects

Looking at the data specifically, primary care shortages will range between 17,800 and 48,000 physicians. And within specialties, surgical shortages will be one of the highest, between 15,800 and 30,200 physicians.

Orlowski notes the number of medical schools and medical education enrollment are up, which is a positive step toward increasing the number of physicians in the U.S.

And at the end of 2020, Congress added 1,000 new Medicare-supported graduate medical education positions—200 per year for five years—targeted at underserved rural and urban communities. New bipartisan legislation called The Doctors of Community (DOC) Act, introduced in the House of Representatives Tuesday and expected to be released in the Senate next week, would permanently authorize the Teaching Health Center Graduate Medical Education program that aims to train primary care medical and dental doctors. The legislation would increase annual funding by more than $500 million per year from 2024 through 2033.

Finally, the pandemic has put a spotlight on disparities in health and access to care among underserved populations in the U.S. The estimates in the survey do not include the additional 180,400 physicians AAMC believes the country would need if there were fewer barriers to access for minority populations as well as if people living in rural communities and people without health insurance were included.

“The issue that I’m probably most worried about is equity,” said Orlowski. “As we take a look at equity throughout the U.S. and how different populations are affected by COVID, it strikingly points out the differences of access and utilization. If everyone had the same access to physicians as those who are living in an urban center, white, not low-income, we would still need more than 180,000 physicians to build equity. And that’s not 15 years from now, that’s today.”

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Time to Rethink Our Approach to Antibiotics?

Fierce Healthcare March 24th, 2024 By Lee A. Fleisher MD

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The COVID-19 pandemic reminded us that our knowledge of infectious disease keeps evolving, inviting us to rethink and improve our public health approaches. 

In this context, one of the greatest health tools humanity has ever discovered, antibiotics, is already becoming less effective and our collective assumptions about the low risk of their use is the key contributor.  While our knowledge of resistance to antibiotics has long existed, the first World Health Organization report was not published until 1998. Today, we have reached a critical juncture.

 

Antibiotics have changed the world and touched most of our lives, making an infected tooth or pink eye from a bacterial infection mostly just a nuisance. Of course, for more serious health threats such as sepsis, antibiotics are a literal lifesaver. Where will we be if we lose this medical tool?  Bacteria, similar to viruses like COVID-19, continue to evolve to evade our treatments.

 

 

Many think of this threat as geographically or theoretically far-off, but Antimicrobial Resistance (AMR) has been around since the beginning of its use and is increasing in frequency, with infections from “superbugs” becoming more common. In fact, some are calling it the antibiotic apocalypse, and a recent Lancet study reported that 1.27 million people around the world have died from an antibiotic-resistant infection. Even here in the U.S. we are seeing more resistant strains of bacteria, often affecting those who are most vulnerable in hospitals and ICUs.

Anyone can become infected with resistant bacteria. AMR is medically democratic. Nature finds a way to survive, and if you overuse the treatment tools, they will stop working for you. If that happens to enough individuals in a community, it will stop working for your community as new colonies of these resistant superbugs thrive. This can translate into a global health crisis. That’s why there is a very real, personal, national and global call to action here.

 

In the U.S. we have three primary issues that we must work together to fix to try to stem the tide on AMR. None are simple, but all are solvable through education and the right tests at the right time.

Awareness

First, we need to broadly educate every person about what requires an antibiotic and what doesn’t. Only some infections can be cured with an antibiotic. Viruses and allergic reactions cannot. Fortunately, we now have tests that can help distinguish the type of infection and doctors and patients need to ask for a test to be sure that your condition requires treatment.

• The “Why not?” effect: Doctors always consider the possibility of a serious reaction to an antibiotic, but as a whole, antibiotics are generally safe, easy to obtain and affordable, leading us to have a “What can it hurt?” mindset.

• We must evolve: Don’t take antibiotics preventatively or without a test confirming you need them.  If you do start an antibiotic before the test result comes back, and the results then do not show a bacterial infection, stop taking it.  Just 20 years ago, it was common that antibiotics were given before and after surgery in the absence of an infection. Today, we either avoid antibiotics or frequently stop them within 24 hours.  Our knowledge has changed and so too must our behavior.

Empowerment

Second, we must empower physicians and other prescribers to stop and take the time to ask a different first question: Not what treatment does this require, rather, does this require a treatment (with an antibiotic) at all?

• To know the answer with certainty requires a test. This takes time, and physicians as we know are overburdened. We also know that physicians don’t want to contribute to this growing crisis, nor hurt their patients in the long run.

• If the results of the diagnostic test show that an antibiotic would help, the next question is, which one? We ask physicians to be the most judicious and use the most specific treatment for the infection.

• If antibiotics are not indicated, the medical community can help educate patients as to why antibiotics won’t help and why the best practices have changed.

Policy 

Finally, since reliable diagnostic results are the key to reducing the threat of AMR, we need to make sure the right policies, incentives and reimbursement is in place to make diagnostics part of the standard of care.

• This will help us create new practice norms, balancing the new requests of our healthcare teams and ensuring testing is affordable to patients.

• AMR is already costing unfathomable loss of life, as well as more than $5 billion extra healthcare dollars a year. We must establish policies that focus on prevention immediately.

Related

CDC report on resistant hospital infections outlines need for federal investment, epidemiology society says

Making diagnostics a critical piece of the care puzzle has an added positive outcome: It provides a new way to track illness and contagion so that we can be better prepared for the next pandemic.

The COVID-19 pandemic taught us the value of knowing our diagnosis with certainty, helping us determine the course of treatment, and reiterating the role of isolation, when necessary, in reducing the spread of disease. This certainty has a ripple effect of helping reduce the spread, and keeping the economy humming when more adults get to work, and more kids go to school.

There’s value in protecting people, and advances in diagnostics must be used to help change our behavior and ensure that our amazing treatments are used appropriately and remain potent.

Lee A. Fleisher, M.D. an anesthesiologist and former Chief Medical Officer at the Centers for Medicare and Medicaid Services. He is currently CEO of Rubrum Advising.

 

Coronavirus Test To Reach ‘General Population’

 

Bruce JapsenSenior Contributor April 17, 2020

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I write about healthcare business and policy

• Abbott Laboratories hopes to begin rolling out its rapid diagnostic test for the Coronavirus strain ... [+]

ASSOCIATED PRESS

Abbott Laboratories hopes to begin rolling out its rapid diagnostic test for the Coronavirus strain COVID-19 to the general population beyond “frontline healthcare workers” in May and into June.

The effort to get the ID NOW COVID-19 test to healthcare workers on the frontlines of the battle against the deadly virus has been the first priority of Abbott amid the daunting diagnostic effort under way in the U.S. Abbott’s ID NOW COVID-19 test can deliver positive results in as little as five minutes and negative results in 13 minutes.

“Our first phase was to roll this out to ensure that the frontline healthcare workers were tested and protected,” Abbott chief executive officer Robert Ford told analysts Thursday on a call to discuss the global medical product company’s first quarter earnings.

Today In: Healthcare

Abbott has been shipping out 50,000 ID NOW tests per day since April 1 and has been delivering on that commitment. “I get to see the manufacturing and the shipment output, and we haven’t fallen behind that,” Ford said. “In several days we’ve beaten that number and able to get more tests out.”

But as Abbott starts to ramp up manufacturing for ID NOW in May and into June, Ford said the company will “start to roll this out into a second phase where we’ll start to be able to test more of the general population.” Abbott will ramp up from production of 1.3 million ID NOW tests a month to 2 million in June.

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Americans are living longer — But we may not have enough physicians

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Kelly Gooch - Tuesday, April 23rd, 2024 Print  | Email

  

The U.S. could face a shortage of nearly 122,000 physicians by 2032, according to data from the Association of American Medical Colleges.

“The nation’s population is growing and aging, and as we continue to address population health goals like reducing obesity and tobacco use, more Americans will live longer lives. These factors and others mean we will need more doctors,” said AAMC President and CEO Darrell G. Kirch, MD, in a news release. “Even with new ways of delivering care, America’s doctor shortage continues to remain real and significant.”

The new data is part of a fifth annual study conducted by the life sciences division of IHS Markit, a global information company, and includes insights on changes expected in the physician workforce by 2032.

Seven takeaways from the study:

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1. The projected shortfall for 2032 ranges from 46,900 to 121,900 physicians and is similar to the projected shortfall for 2030 of 44,900 to 121,300 physicians in the 2018 report.

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2. The latest study’s projected shortfall includes primary care (between 21,100 and 55,200) and specialty care (between 24,800 and 65,800).

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3. The projected shortfall for 2032 comes as demand growth for physicians continues to outpace supply growth, according to the study.

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4. Association officials said the primary driver of increasing demand for physicians through 2032 is still demographics — particularly, population growth and aging.

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5. Achieving population health goals — such as reducing excess body weight and reducing smoking  — will increase demand for physicians in the long term, according to the study. “Although prevention efforts likely will reduce demand for some specialties, like endocrinology, demand for other specialties, like geriatric medicine, will increase,” AAMC added.

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6. Regarding supply, IHS Markit analyzed American Medical Association data and found that more than two out of five currently active physicians will be 65 or older within 10 years, and changes in physician retirement decisions could affect supply the most.

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7. The AAMC, along with more than 70 healthcare stakeholders, is backing legislation that would help address the national physician workforce shortage by adding 15,000 Medicare-supported residency positions between 2021 and 2025.

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