Primary care physicians (PCPs) are instrumental to comprehensive healthcare management, particularly in providing common treatments and tracking patient care across time. Alarmingly, a 2018 study by the American Association of American Medical Colleges reported that the United States will face a shortage of PCPs—between 21,100 and 55,200—by 2032. According to their research, the driving factor behind the increasing demand for medical capacity is the fact that our population is growing and aging—per the census, the country’s population is predicted to grow by over 10% by 2032, with individuals over age 65 increasing by 48% . Another factor worth consideration is the nation’s obesity epidemic, which has seen marked increases in chronic health conditions nationwide. Additionally, recent medical graduates heavily consider monetary (as well as other logistical) incentives in pursuing specialized careers within medicine, as they are typically higher earning than those within primary care fields.
Furthermore, a 2019 article in the Washington Post illuminates the way in which the medical school “match” process facilitates physician specialization (including primary, internal, or family medicine) and plays a complex, yet crucial role in the impending shortage . Roughly 13% of U.S. patients currently live in a county experiencing a “primary care shortage”—defined as “having less than one primary care physician per 2,000 patients” . Notably, while PCP shortages are predicted to take place across the country, the worst of its effects are felt in rural regions, where communities are five times more likely to be facing a primary care shortage than urban and suburban counterparts .
Luckily, research indicates that nurse-practitioners (NPs) and physician assistants (PAs) are viable and well-positioned members of healthcare teams and providers who may ultimately increase patient access to care in coming years—ideally, helping combat predicted PCP shortages [2, 3, 4]. However, this is assuming a ‘best-case-scenario’—that is, that NPs and PAs can be effectively integrated in most, if not all, medical settings. Under such hopeful circumstances, the government’s Health Resources & Services Administration (HRSA) Bureau of Health Research predicts that the expected shortage of 20,400 PCPs in 2020 could be reduced to 6,400, thereby considerably reducing public health risks . Collective studies indicate that significantly curbing the PCP shortage will require the expansion of state and national regulations necessary for NPs and PAs to be able to practice to the fullest extent of their knowledge, employing their extensive training focused in primary care and prevention. Another avenue presently being explored and employed is the recruitment of foreign-trained medical doctors to assuage healthcare deficits in the U.S.
In combating this monumental health issue, one must surely employ complex, multi-tiered approaches and strategies necessary for combatting this, literally, life-threatening shortage [3, 4]. The nation’s healthcare leaders must critically examine viable and timely strategies to confront the unfavorable consequences of PCP shortages nationwide. Indeed, earlier this year, lawmakers introduced to Congress the bipartisan Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763) to promote Medicare services for an added 3,000 residency positions annually for the next five years . In summary, there is no doubt that resolving the U.S.’s PCP shortage will be a complex challenge—but one that is already being collectively and collaboratively tackled.
New Research Shows Increasing Physician Shortages in Both Primary and Specialty Care.” AAMCNews, May 8, 2019. https://news.aamc.org/press-releases/article/workforce_report_shortage_04112018/.
Knight, Victoria. “Numbers of Doctors Choosing Primary Care Declining.” The Washington Post. WP Company, July 15, 2019. https://beta.washingtonpost.com/health/america-to-face-a-shortage-of-primary-care-physicians-within-a-decade-or-so/2019/07/12/0cf144d0-a27d-11e9-bd56-eac6bb02d01d_story.html?noredirect=on#targetText=Despite osteopathic graduates and foreign,primary care physicians by 2032.
Heath, Sara. “NPs, PAs Could Reduce Primary Care Physician Shortage Nearly 70%.” Patient Engagement HIT, September 17, 2018. https://patientengagementhit.com/news/nps-pas-could-reduce-primary-care-physician-shortage-nearly-70.
Projecting the Supply and Demand for Primary Care Practitioners Through 2020.” HRSA Bureau of Health Workforce, October 31, 2016. https://bhw.hrsa.gov/health-workforce-analysis/primary-care-2020.