By: Allison McCarthy, MBA | amccarthy@barlowmccarthy.com

The Association of American Medical Colleges (AAMC) recently released the 2017 update to its Physician Supply and Demand Projections.  While demand still outweighs supply is still the overall conclusion, the shortfall is lower than previously projected.

Researchers used various scenarios to compare demand/supply – testing many of the factors considered to be the “fix” to the pending physician shortage.

Demand

Supply
Changing demographics Early or delayed retirements
Improved care coordination Millennial hours worked
Expanded use of retail clinics GME expansion
Increased use of ACPs

Population health improvements

Key Findings 

  • In primary care, the use of nurse practitioners will increase the total supply of providers
  • Medical specialties also have increasing supplies with more physicians choosing internal medicine and pediatric subspecialties
  • Surgical specialties see no improvement as future attrition will meet or exceed the number of newly trained surgeons
  • Growth in the senior population will be the primary driver of physician demand – much higher than the demand for pediatric services
  • For all specialties, physician retirement decisions will have the greatest impact on supply with over one-third of today’s active physicians turning age 65+ within the next decade
  • The use of NPs and PAs will increase. By 2030, the ratio of physician-to-PAs will go from 7.2:1 to 3.5:1 and physician-to-NPs from 3.6:1 to 1.9:1
  • Population health improvements may actually increase the demand for physicians. By 2030 there will be 6.3 million more living adults who will require an additional 15,500 FTE physicians

Every organization should assess the implications of these demand/supply dynamics on their own provider community.  Having a current medical staff development plan provides a baseline understanding of the local specialty gaps and pending retirements.  From there, these additional factors can be considered.

  1. What is the starting point with primary care physician-to-ACP ratios? What is the organization’s future goal and by when?  What is the tactical plan to reach that target?
  2. If medical specialties (other than psychiatry) are becoming easier to recruit, which ones would improve primary care physician demand if recruited? Which ones are needed for chronic care management or for the growing senior population?
  3. If physician attrition will have the greatest impact in the surgical specialties, does this change the list of physicians that need to be considered for transition planning?
  4. What percentage of your population is over age 65… over age 75? How does that compare to your region, state and nationally?  What services need to be considered to manage this population going forward?
  5. If one of the strategic service lines includes pediatrics, how will the organization address the decline in this population demographic?
  6. Do your physician recruitment priorities need to shift in any other way? If so, what advance work is needed to be ready for those searches.

We’re here to help the organization work through these implications – whether its updating the medical staff development plan or conducting a facilitated strategy session using the existing plan as the framework.  Contact me at amccarthy@barlowmccarthy.com to discuss how we might help you improve your recruitment and retention positon for the future.