As a dedicated physician recruitment partner, we read articles like this report from the Association of American Medical Colleges (AAMC) updating projections about the U.S. physician shortage with interest, understanding that the long-entrenched shortages facing our industry will not end anytime soon and curious for any nuance in the numbers that can help us recruit providers in smart and strategic ways.
According to the latest projections in the March 2024 study, The Complexities of Physician Supply and Demand: Projections From 2021 to 2036, the U.S. will face a physician shortage of up to 86,000 by 2036, driven by the aging population and an increasing number of retiring physicians. The report highlights the need for continued investment in medical education, including expanding Medicare-supported residency positions.
None of this is very different from previous projections, and much of it is familiar based on our experience placing physicians in every healthcare setting — urban, rural, and suburban areas — and in all specialties of practice as well as in physician executive leadership positions.
What’s Behind the Physician Shortage?
“It’s important to look past the numbers and recognize the additional challenges that lie behind them,” advises Tara Osseck, Partner and Regional Vice President of Recruiting at Jackson Physician Search, serving markets in the Midwestern U.S. “While it is true that medical schools have increased enrollment,” said Tara, “We are still hearing about other factors that are limiting their ability to match into residency programs or pursue clinical practice.” According to Tara, the complicating factors include:
- The fact that the cap on residency funding imposed by Congress has not been significantly lifted and the imbalance between the number of graduates and the residency slots available results in otherwise qualified candidates being unmatched each year
- The increase in International Medical Graduates (IMGs) who add to our physician count but compete for limited residency slots
- The ongoing mismatch between specialty preference and the number of residency positions available, especially in highly competitive specialties like dermatology
- The number of physicians who pursue alternate career paths, such as consulting, research, insurance, pharma, etc., which are becoming more appealing because they are perceived as being less stressful career paths that provide sought-after benefits such as work/life balance
- Finally, no list of barriers is complete without recognizing that burnout remains pervasive
Additionally, even with more funding to expand residency slots, there are structural issues with our healthcare system that may further exacerbate the shortage, explains Helen Falkner, Partner and Regional Vice President of Recruiting for Jackson Physician Search based in Denver and serving the Mountain West. “The challenges with recruiting physicians into rural and underserved settings, as well as the high cost of medical education, continue to be barriers to expanding our physician population. We also need to take into account the growing healthcare needs of an aging population likely to need more acute care.”
Helen also notes that the AAMC report projects a surplus of some medical specialties, which rings true to her team’s experience recruiting in the largely rural West. “Over the last several years, we have seen a move away from the traditionalist to subspecialties. Internal Medicine is a great example of this trend, with almost 90% of Internal Medicine residents pursuing fellowship training. Neurology is another example, with about 75% of Neurology residents pursuing fellowship training.” This trend makes it even harder to fill generalist positions.
Where Are the Bright Spots in Physician Recruiting?
Tara points out that a bright spot in the Midwest is found in the many organizations that are increasingly open-minded about offering sunsetting physicians the opportunity to extend their careers while offering better work/life balance. “For example, some of our clients are slowing daily patient volume or call responsibilities for older physicians in an effort to delay retirement while expanding patient access,” said Tara. “Senior physicians are often amenable to move into part-time positions or transition to non-patient facing roles. And those who do it report improved outcomes.”
The AAMC makes one distinction that brings the twin challenges of physician shortages and access to care into focus, and that is that “if communities underserved by the nation’s health care system could obtain care at the same rate as populations with better access to care, the nation would have needed approximately 202,800 more physicians as of 2021.” This incredibly sobering statistic brings a renewed sense of urgency to the task of finding strategic and creative ways to recruit and place physicians.
“Finding better ways to reach our underserved communities, including extending the reach of care with APPs and telehealth, is critical to solving the access issue,” said Tara.
Three Tips for Managing the Physician Shortage
While circumstances contributing to the physician shortage are largely out of your control, there are steps healthcare leaders can take now to reduce the impact of nationwide physician shortages at their organizations.
1. Focus on Physician Retention
While your instinct may be to prioritize recruitment strategies in response to news that physician shortages aren’t changing, the first line of defense is actually to retain your existing staff. Ideally, you have a formal physician retention program designed to support physicians where they are in their lives and careers. For example, reducing hours and increasing flexibility for sunsetting physicians and bringing in APPs to reduce the burden on overworked providers.
Also, consider a personalized physician onboarding program, ongoing efforts to improve physician job satisfaction, and giving physicians a clear path to increased compensation, bonuses, and leadership opportunities. Offering this type of ongoing support will make you an employer of choice and differentiate you from other organizations.
2. Revisit Your Staffing Plan
Once you have shored up your retention program, get a clear idea of exactly who, what, and when you need to hire. You’ll need to revisit (or create) a medical staffing plan that considers a number of factors:
- The projected departures of current staff, including physician retirements as well as others approaching the average tenure for your organization who might be likely to leave.
- Other known upcoming absences, such as parental leave and sabbaticals, should also be noted and factored into recruitment needs.
- Consider also the anticipated growth of your organization. How many and what kind of staff will you need to meet your organizational goals and community demand?
- Who among your current staff may be ready to step into a leadership role? This type of succession planning will help you determine what kind of physicians or advanced practice providers you need to hire.
3. Identify a Physician Recruitment Partner
Effectively executing on your staffing plan can be challenging as you endeavor to minimize the impact of staffing shortages. A permanent physician recruitment partner can serve as an extension of your team, helping you to create a recruitment timeline based on your medical staffing plan and the market data on time-to-fill for various physician specialties. Recruiters may even have creative alternatives for those positions that seem impossible to fill.
If your organization is seeking physicians, the Jackson Physician Search recruitment team is eager to leverage our experience and expertise to help you find the best candidates for your organization. Reach out today for more information.
