Roosevelt Institute | Cornell University

Doctor Shortage in the United States

By Amy KimPublished February 25, 2016

While the ACA has increased insurance coverage to insure an aging American population that is characterized by chronic and degenerative diseases, the supply of doctors is shrinking. Fortunately, technological advances and telemedicine help create reasons to remain optimistic.

There is currently a doctor shortage in the United States. A study by the Association of American Medical Colleges indicates that by 2025, the U.S. will face a shortage of 46,000 to 90,000 physicians.5 Longer life spans and aging baby boomers will continue to double the population of Americans 65 years and over to approximately 72 million within the next quarter century.4 The leading causes of death have shifted from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.4 The increase in insurance coverage through the Affordable Care Act also increases the demand for doctors and specialists1 while the medical school capacity is not improving.3 Therefore, almost 20% of US citizens live in regions with a lack of primary care doctors.1 Clearly, there is a shrinking supply of physicians relative to the growing demand for health care services.
Going forward, there will be a critical need for specialists and more so for primary care physicians to treat an increasingly older, sicker population. Statistics show that 20% of Americans do not have access to primary care doctors, 16% live in areas with a shortage of dentists, and 30% live in areas with a shortage of mental health providers.1 Created through the Patient Protection and Affordable Care Act, the Teaching Health Center Graduate Medical Education Payment Program, which awarded $83.4 million in funding to support primary care residency programs at 60 teaching health centers, expired at the end of the federal fiscal year 2015 with no further plans of being renewed.3 Adding to the problem is the fact that medical school capacity is not improving to increase the supply of doctors. The average acceptance rate for medical students is a little less than 50%3 during a time of rising need for physicians all over the country. Many students are unable to finish their licensure because of the federal budget cuts previously mentioned. And if they do, medical students are choosing careers in specialized medicine instead of primary care, where more doctors are needed.6 A report in the Academic Medicine found expenses to exceed earnings for the first three to five years for primary care physicians6; this greatly disincentives students from pursuing a career in primary care who still have to pay off their student loans. Therefore, the shortage in primary care is more prominent than that in specialized fields.  
In an attempt to address the looming shortage, the United States government has been running various programs to encourage doctors to practice in shortage areas because it has been found to be the case that certain types of doctors are clustered in cities and affluent areas where the salary is higher. Some states have provided incentives like helping doctors pay off their medical school debt if they agree to practice in underserved parts of the country.2  
Given all this, there still remains reason to stay optimistic. Although the Association of American Medical Colleges warns that the United States faces a 90,000 doctor shortage by 20252, the projected shortage may not occur to the extreme that estimates predict.2 Technological advances may be able to extend how far medicine reaches to help ameliorate the shortages.  There have been efforts to move towards comprehensive electronic health records that streamline patient care and make patient visits more efficient. Furthermore, there has been a move towards larger practices, which allows physicians to share support staff and office space, Consequently, this would make it possible for physicians to see/treat more patients everyday. Telemedicine is another method through which hospitals and health systems can utilize the current supply of physicians more efficiently. Now with telemedicine, rural hospitals can connect to specialists and enable patient access to a wider pool of physicians.3

There is a shortage of physicians it the United States but that shortage can hopefully be overcome to a small degree through telemedicine and larger practices that make patient care more efficient and effective. Policy makers and healthcare providers must conceptualize innovative policies and strategies that incorporate technology to address the doctor shortage that we have in the United States.