The healthcare sector is at a “tipping point,” Atul Grover, executive director of the Association of American Medical Colleges’ (AAMC) Research and Action Institute, told MedPage Today in September 2022. Physicians, increasingly plagued by burnout, are leaving the profession, or poised to do so. Those few who remain are left to deal with the needs of an aging population.
A little over a year earlier, The Organisation for Economic Co-operation and Development (OECD) quantified the extent of the problem. The U.S., that organization noted, features just 26.1 physicians per 100,000 people, putting it far down the list of developed countries. Austria, which heads the list, has twice as many – 52.4 – including 16.4 primary care physicians. The U.S., by contrast, has just 3.1.
Nor is there any indication that the problem is about to dissipate. By June 2033, there is expected to be a shortage of between 54,100 and 139,000 doctors, according to the Association of American Medical Colleges (AAMC). That includes a shortage of between 21,400 and 55,200 primary care physicians.
Dr. Scott Harmon, past president of the American Medical Association, wrote in March 2022 about the issue. First he cited a December 2021 Mayo Clinic Proceedings piece asserting that 20 percent of doctors and 40 percent of nurses, having endured pandemic-related stress, are looking to depart the profession within the next two years. Then he pointed out that large numbers of physicians, like workers in other fields, are aging out of the workforce.
His conclusion was that the shortage “is not just a crisis for tomorrow; it demands our attention today.”
James Taylor, president of AMN Healthcare’s leadership solutions division, called it “a looming public-health crisis” in a July 2022 interview with Time Magazine, and noted that the dearth of doctors has been most keenly felt in rural and underserved areas.
That piece goes on to list several potential solutions, starting with increased funding for residency programs. That was also mentioned by Robert Orr, a policy analyst for a think tank called the Niskanen Center, in a February 2022 piece in The Atlantic, and is addressed in the Resident Physician Shortage Reduction Act. Alas, that bill has made little progress since its introduction in the U.S. Senate in 2021.
Student-debt relief, another focal point of the Biden Administration, could also play a role, particularly in the primary care realm. As it stands medical students are far more likely to specialize, as that is a more lucrative route. And the average debt load for such students, according to an Education Debt Initiative estimate quoted by Time, is a staggering $200,000.
Not to be forgotten, either, is the need to redouble diversity efforts. A 2021 study showed that only 5.4 percent of physicians are Black, and that that ratio has risen only four percent over the last 120 years.
The Time piece also suggests that a shift toward multidisciplinary care teams and increased dependence on technology such as telehealth are also moves that can ease physicians’ burdens.
Certainly the challenge is daunting. Certainly it will not be easy to counter this crunch. But as Harmon said, the time to act is now. There is not a moment to wait, as these issues will only worsen in the years to come.
