The Association of American Medical Colleges publishes an annual report outlining the state of physician supply and demand, and their most recent study completed in 2019 confirmed that the United States may see a shortage of nearly 122,000 physicians by 2032. In addition to an overall shortage of primary care physicians, Oncology and Surgery are projected to be the hardest hit specialties. Strictly looking at the data regarding oncology, new cancer cases are projected to increase by 42% within five years, while the number of oncologists is only expected to increase by 28%. More than ever before, hospitals and medical system administrators are being forced to place greater emphasis on physician recruitment and retention. Let’s look at some of the factors that are contributing to physician demand challenges.
The Aging Population.
Americans are living longer than ever, and those over the age of 65 are projected to grow by 50%. An aging population means that more individuals are managing chronic and age-related conditions. At the same time, more than one-third of all physicians will be 65 or older by 2030.
The Residency Conundrum.
Even though medical schools are increasing their class sizes, the number of available residency slots have not increased commensurately. Legislation to increase Medicare-supported residency slots by 15,000 over five years has been stalled in the U.S. Congress for the past two years.
Burnout and Flexible Scheduling.
As physicians suffer from burnout and stress at higher levels than in the past, many are negotiating reduced and more flexible scheduling to create better work/life balance. As many as 78% of physicians report experiencing burnout, and when they combat the stress by reducing their work hours, the effect is a reduction in the number of full-time physician equivalents.
In a 2019 MGMA survey, 76% of respondents cited increasing regulatory burdens as impacting their ability to practice medicine. More than half stated that the forced administrative overload is contributing to their likelihood of retirement within five years.
As the documented physician shortage continues to worsen, here are several solutions that can be enacted to ease the burden.
Lifting Residency Caps.
With the unfortunate state of gridlock in Washington, D.C., Congress could pass the bipartisan legislation that eases the limits on the number of residency slots. As written, the legislation calls for an additional 3,000 residency slots each year for five years as a means to increase the number of practicing physicians.
Improve the licensing process for international med school grads.
With almost 25% of today’s physician workforce comprised of international medical school graduates, the archaic and cumbersome licensure process should be streamlined for efficiency. While relying on lawmakers to pass legislation to simplify the licensing process is unlikely at best, if the gridlock loosens, this would be a logical step.
Competition breeds creative compensation models.
Let’s face it, competition for physician services is fierce. Salaries are on the rise, but even that isn’t guaranteeing recruitment success. Administrators are becoming increasingly creative by including flexible scheduling, reduced or no call hours, signing bonuses, and student loan forgiveness to attract candidates to ongoing vacancies.
Increase non-physician utilization and technology.
Anyone who has tried to schedule a primary care appointment recently has most assuredly been offered a visit with a physician’s assistant or nurse practitioner to get into the office sooner. Healthcare administrators are working hard to balance their staffing with an increased mix of “non-physician” practitioners. In concert with that, technology innovations are supplementing the monitoring and management of chronic conditions to reduce the need for frequent office visits.
Speaking of technology and other changes that are impacting healthcare delivery and practice settings, let’s review a few trends that may affect physician career planning.
The Rise of Hospital and Large System Employment.
During the age of buyouts and mergers over the past decade, the percentage of physicians employed by hospitals and health systems has grown significantly. Even though buyout mania has abated to a degree, there is still a large percentage of doctors who are employed by a health system, and fewer who are independent or a part of a small group practice.
Physician burnout is well-documented, and one of the ways frustrated doctors are alleviating the burdensome relationship with insurance reimbursements is by turning to a concierge-style practice. Concierge medicine is a private, subscription-based practice that is growing by as much as 6% annually. According to Concierge Medicine Today, a national trade publication, there are estimates of up to 20,000 physicians practicing concierge medicine.
Telehealth Acceptance and Growth.
More than half of all U.S. hospitals currently have a telehealth program, and almost 90% of healthcare administrators in a recent survey responded that their organizations have already begun developing a telemedicine program. With telehealth initiatives on the rise, research indicates that almost 74% of patients in the U.S. would be comfortable utilizing technology to communicate with their physician instead of scheduling an in-person office visit. Currently, about 30% of patients are already using computers or mobile devices to monitor their medical or diagnostic information.
Ever since the Affordable Care Act ushered in the age of high-deductible healthcare plans, patients are forced to treat their healthcare decisions as they would any other consumer-based transaction. Today’s healthcare consumers are putting more effort into making informed decisions and shopping for services. This has led to more competition in the healthcare marketplace, and in response, providers have to inspire loyalty and keep their patients engaged as a retail outlet would with any customer. Patients are now prone to post and read online reviews about a provider and are demanding more transparent pricing. All of this is increasingly being used to determine where a patient seeks care or if they will leave one provider for another.
This has been the first installment in a new Jackson Physician Search Series on the career outlook for practicing physicians. In our next installment, we will do a deep dive into what career options are available in the healthcare environment today.
If you are looking for your next career move, contact the experienced recruitment professionals at Jackson Physician Search today.