Physician Shortage

Physician supply is a term that is used to describe the number of trained physicians who work in a healthcare system or labor market. It is dependent on the number of graduates, and the retention rates of the profession. Physician shortage is a growing concern in many countries around the world, due to a growing demand for physicians that outmatches the supply.

The World Health Organization (WHO) estimates that there is a global shortage of 4.3 million physicians, nurses, and other health professionals. The shortage is often starkest in developing nations due to the limited numbers and capacity of medical schools in these countries.

Additionally, rural and remote areas also commonly struggle with a physician shortage the world over.

Effects of Physician Shortage

When there is a shortage of physician to provide healthcare services to a population, a number of effects inevitably become evident in the health system, including:

• Lower quality care
• Time constraints on doctor-patient interactions
• Increased workload for healthcare practitioners
• Overworked and stressed practitioners
• Unnecessarily prolonged wait time before consultations
• Higher prices for consultations

Projected Supply and Demand

Despite the projections of a modest growth in the supply of physicians by 2025, the demand for physicians is growing at a faster rate than the supply.

The demand for physicians is projected to grow by 17 percent by 2025, due primarily to the growth in population size and the aging population. The population below 18 years is projected to grow by 5%, whereas the elderly population over 65, who typically require more care from physicians, is expected to grow by 41%.

In addition, over a third of physicians today are over the age of 55, and less than half of primary care physicians are available for after-hours attendance. Thus primary care after traditional office hours is usually given in the emergency room. Long waits in the doctor’s office are now part of the expected situation, pointing to an obvious shortage of primary care physicians.

By 2025, it is projected that the demand for physicians in the United Stated will exceed the supply by 46,000 to 90,000. This comprises a shortage of:

• 12,500 to 31,100 primary care physicians
• 5,100 to 12,300 medical specialists
• 23,100 to 31,600 surgical specialists
• 2,400 to 20,200 other specialists

This shortage of physicians is likely to have a considerable impact on the health of the population. Most scientists believe that it will persist even with the introduction of compensatory scenarios such as:

• advanced nurse practitioners (APRNs)
• retail health clinics
• delayed physician retirement
• more efficient delivery of services

Increasing Number of Primary Care Physicians

The supply of primary care physicians is linked to the achievement of better health outcomes. These include overall health, life expectancy, better perception of self-rated health, and mortality from all causes, cardiovascular disease, stroke and in infancy. This relationship has been evident with repeated trials over the previous thirty years in the United States.

Research suggests that increasing the number of primary care physicians by one per 10,000 people is associated with a 5.3% reduction in average mortality (which is presently 49 per 100,000 per year).

The need for primary care physicians is usually estimated based on the tasks they are expected to carry out, and the time required to maintain health programs, rather than the benefits of their contribution. Based on this approach, there was predicted to be a surplus of primary care physicians in the early 21st century.

Surprisingly, reanalysis has found that there is currently a growing shortage in their supply. It is important that the benefits of primary health care and the projected need are clearly outlined so that the needs can be met as well as possible.

Addressing the Physician Shortage

Solving the shortage of physicians in primary care will require a wide-ranging approach, with changes in several aspects in the way physicians provide health care.

• Innovative care delivery
• Increased use of technology
• More efficient teamwork among health professionals
• Increased funding and planning for the training of residents

A stand-alone solution is unlikely to be sufficient in addressing the issue of physician shortage. The training of new doctors takes up to a decade. It is, therefore, important, that several measures to resolve this shortage in supply are initiated from today and going forward.

References

• https://www.aamc.org/download/426260/data/physiciansupplyanddemandthrough2025keyfindings.pdf
• https://www.aamc.org/download/457558/data/physician_supply_demand_2025_keyfindings_2016update.pdf
• https://www.aamc.org/newsroom/keyissues/physician_workforce/
• http://www.who.int/bulletin/volumes/86/7/07-046474.pdf
• http://www.ncbi.nlm.nih.gov/pubmed/18953810