Will we have enough primary care physicians in upcoming years?
Implementation of the Affordable Care Act plus an increase in US population in general and among seniors will necessitate a significant increase in the number of primary care physicians. The obvious question is: Will we have enough of these physicians to meet our needs? Many healthcare experts feel that the answer is “no.” Stephen M. Petterson, PhD, who is affiliated with the Robert Graham Center, Policy Studies in Family Medicine and Primary Care in Washington DC, and colleagues published their findings in the November/December issue of Annals of Internal Medicine.
Before Congress enacted the Affordable Care Act in 2010, the Association of American Medical Colleges had forecast a shortfall of 46,000 primary care physicians by 2025. However, its passage will increase the need of these doctors. In view of this situation, the researchers attempted to project the number of primary care physicians required to meet US healthcare utilization needs through 2025 after passage of the Affordable Care Act.
To develop their projection of workforce needs, the authors accessed the Medical Expenditure Panel Survey to calculate the use of office-based primary care in 2008. They used US Census Bureau projections to account for demographic changes and the American Medical Association's Masterfile to calculate the number of primary care physicians and determine the number of visits per physician. The main outcomes were the projected number of primary care visits through 2025 and the number of primary care physicians needed to conduct those visits.
The authors projected that, driven by population growth and aging, the total number of office visits to primary care physicians is projected to increase from 462 million in 2008 to 565 million in 2025. After incorporating insurance expansion, the US will require almost 52,000 additional primary care physicians by 2025. They noted that population growth will be the largest driver, accounting for 33,000 additional physicians, while 10,000 additional physicians will be needed to accommodate population aging. Insurance expansion will require more than 8,000 additional physicians, marking a 3% increase in the current workforce.
The authors concluded that population growth will be the greatest driver of expected increases in primary care utilization. Aging and insurance expansion will also contribute to utilization, but to a smaller extent.
Take home message:
I agree with the majority of healthcare analysts that the shortage of primary care physicians will increase in the near future. This study estimated the additional number of primary care physicians needed to accommodate the increased demands by population growth, an increase in the senior population, and the Affordable Care Act. However, another factor is likely to add to the shortage. Many physicians have threatened to cease practicing when the Affordable Care Act is implemented. Some of these doctors will continue to soldier on; however, a significant number will quit. Many physicians are already struggling with the double whammy of decreased reimbursement and rising costs for the running of a medical practice. I am personally aware of a number of fine physicians who are currently enduring stress and financial difficulties. Sadly, many of the struggling physicians are the ones most valued by patients. They are the ones that take extra time with each patient to fully address his or her needs. Physicians who see a high patient volume with a rapid turnover are faring better.
Reference: Annals of Family Medicine