Physician shortages
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Physician Shortages. Prepared by: Shaheena Patierno, MSIII SUNY Upstate Medical University. 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:

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Physician Shortages

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Physician shortages

Physician Shortages

Prepared by:

Shaheena Patierno, MSIII

SUNY Upstate Medical University


Current forecasts

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


Shortage in er physicians

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


Shortage in primary care physicians

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


Factors causing shortage in primary care physicians

Factors Causing Shortage in Primary Care Physicians

  • Disparity in incomes

    • Lower total reimbursement

    • Medicare’s 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


Uneven distribution of providers

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 (<50,000 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


Possible solutions

Possible Solutions

  • Increase the number of physicians in production annually.

  • Increase incentives for entering primary care.

  • Optimize distribution of physicians.


Conclusion

Conclusion

  • Severe physician workforce shortages

  • Incentives needed to encourage Emergency Medicine and Primary Care

  • Better physicians distribution needed


References

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 Medicare’s 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.


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