The COVID-19 pandemic has changed our lives in profound ways, but it has also accelerated a crisis in health care that is not so easily seen: a severe physician shortage over the next decade to care for an aging U.S. population and increasing rates of diabetes, heart disease and other chronic ailments.
Some estimates say the shortfall could reach more than 120,000 physicians nationwide by 2034, with the greatest gap occurring in primary care. Many of those who worked tirelessly and heroically during the pandemic have decided they have had enough. A December 2021 article in Mayo Clinic Proceedings showed that one in five doctors said they planned to leave the profession within the next two years. Many more planned to reduce their work hours over the next 12 months. If only a portion of them follow through with their plans, the impact on U.S. health care would be substantial given ordinary circumstances — and potentially devastating amid a new or resurgent public health emergency.
The demographics of the physician workforce, and of the U.S. population overall, must also be considered. More than two of every five active physicians will be age 65 or older within the next decade, which will almost certainly compound the workforce reduction tied to pandemic-related burnout. And a greater number of physicians who might choose to retire earlier than previously planned cannot be ruled out.
Meanwhile, the U.S. population is expected to expand by more than 10 percent over that same time to an estimated 363 million people — more than 42 percent of whom will be 65 or older. Experience tells us that elderly patients demand sharply higher levels of care due to greater incidence of chronic disease with complications, which will likely place much greater demand for physician services on a smaller pool of available physicians.
How should we respond? We can start by taking a hard look at how we nurture and grow our physician community in the U.S., taking steps to make it more inclusive and accessible to a more diverse group of bright young people. The organization I lead, the American Medical Association (AMA), has spent nearly a decade convening leading medical institutions through our Accelerating Change in Medical Education and Reimagining Residency initiatives, to inspire and enable innovative approaches to physician training, including competency-based approaches, which means some students could graduate more quickly.
Policymakers also must contribute solutions. We applaud Congress for providing funding for 1,000 new Medicare-supported physician training positions in the $2.3 trillion Consolidated Appropriations Act of 2021. This is a step in the right direction but nowhere near sufficient. That’s why the AMA is urging Congress to expand federal support for graduate medical education through measures such as the Resident Physician Shortage Reduction Act (S. 834), which would gradually provide 14,000 new Medicare-supported physician training positions.
Because it can take up to a decade to properly educate and train a physician, we need to take action now to ensure we have enough physicians to meet the needs of tomorrow. The health of our nation depends on it.
Gerald E. Harmon, M.D., is president of the American Medical Association.