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Physician supply

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623:(WHO) estimates a shortage of 4.3 million physicians, nurses and other health workers worldwide. The WHO produced a list of countries with a “Human Resources for Health crisis”. In these countries, there are only 1.13 doctors for every 1,000 people, while in the United States, there are approximately 2.5 doctors for every 1,000 people. One quarter of physicians practicing in the United States are from foreign countries. Thousands of foreign doctors come to practice in the United States each year while only a few hundred doctors from the United States leave to practice in foreign countries even short-term. 17: 1102: 2419: 434: 134: 2427: 667: 425:
the supply of Medicaid physicians to fluctuate. A study examining variation between states in 2005 showed that the average time for Medicaid reimbursements was directly correlated with Medicaid participation, and physicians in states with faster reimbursement times had a higher probability of accepting new Medicaid patients.
417:, across the country. Expanded coverage is predicted to increase the number of annual primary care visits between 15.07 million and 24.26 million by 2019. If stable levels of physicians' productivity are assumed, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate that increase. 424:
physicians. Incentives and higher reimbursement rates may have increased the number of physicians accepting Medicaid patients up to 2014. With the expansion of Medicaid and a decrease in incentives and reimbursement rates in 2014, the supply of physicians in Medicaid may drop substantially and cause
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and creates issues on maintaining sufficient physician supply. However, higher-income countries can also experience an outflow of physicians who decide to return to their naturalized countries after they have received extensive education and training, and such nations never benefit from their gained
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There are thousands of women in the United States who live in counties that do not have obstetrical care available. Arizona has two counties with no care available for pregnant women. Awareness to the lack of access to care is increasing in Arizona, and the Phoenix area seems to be heading toward a
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However, the extent of substitution of physician production is limited by technical and legal factors. Technology cannot replace all skills possessed by physicians, such as surgical skill sets. Legal factors can include allowing only licensed physicians to perform surgeries but nurses or doctors to
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medical news blog, for example, it has been argued that inefficiencies introduced into the healthcare system, often driven by government initiatives, have reduced the number of patients physicians can see. By forcing physicians to spend much of their time on data entry and public health issues, the
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Changes in the practice environment; for example, changing legal conditions have been cited in the US, Canada and elsewhere as inciting physician attrition, notably the adoption of laws that require doctors to refer for certain procedures (such as abortion or sex change) with which the doctors
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since physicians can usually earn much more money and enjoy better working conditions in other countries. Many developed countries also report doctor shortages, which traditionally happened in rural and other underserved areas. Reports as recent as January 2019 show that high-growth areas like
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can replace some of the financial responsibilities for a physician who owns their own practice and allow for more time to treat patients. Disposable supplies can substitute for labor and capital (the time and equipment needed to sterilize instruments). Sound record keeping by physicians can
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doctor will serve in the temporary absence of another physician. These positions are typically 1-year placements but can vary by location, specialty, and other factors. Agencies that attempt to provide international aid in various ways often have a strong medical component. Some of these
619:(AAMC) estimates a shortage of 91,500 physicians by 2020 and up to 130,600 by the year 2025. However, a bias would clearly exist in their estimates as expanding medical education serves the direct financial needs of the AAMC. As previously mentioned, the 524:
To address physician shortages in rural areas, develop, organize, and locate medical schools to increase the propensity of physicians entering rural practice. Accepting medical school applicants from rural areas can also increase the proportion of rural
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says that federal funding is the most important limitation in the supply of physicians. The high cost of tuition combined with the cost of supporting themselves during medical school discourages some people from enrolling to become a physician. Limited
168:(GDP). Theoretically, as GDP increases, the health care labor force expands and, in turn, physician supply also increases. However, developing countries face additional challenges in retaining competent physicians to higher-income countries such as the 626:
There are various organizations that assist United States physicians and others in serving internationally. These organizations may be filling temporary or permanent positions. Two temporary agencies are Global Medical Staffing and VISTA staffing. A
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Lower medical costs to consumers; compared to other industries, as market share grows and competition declines, physicians are less inclined to gross up the frequency or intensity of medical services to maximize reimbursement per limited patient
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in place for health care delivery and financing in a jurisdiction, and also the international job market (e.g. the increasing demand in other countries puts pressure on local competition). As of 2010, the WHO proposes a ratio of at least one
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balance. If the number of physicians is decreased or the demand for their services increases, an undersupply or shortage can result. If the number of physicians increases or demand for their services decreases, then an oversupply can result.
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with a duration longer than that of a typical undergraduate degree. Consequently, physician supply is affected by the number of students eligible for medical training. Students who do not finish earlier levels of education, including
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Loosen the requirements for entry to medical school, such as eliminating the need for a pre-med bachelor's degree as required in some jurisdictions, thereby making the education path more attractive for potential
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and goals in place of the health care system. If more physicians are trained than needed, supply exceeds demand. If too few physicians are trained and retained, some people may have difficulty accessing
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Are unable to find work of their choice; studies in Mexico have found high levels of unemployment among trained physicians in urban areas even while large rural populations remain medically underserved.
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Cohen, Steven A. (2009). "A review of demographic and infrastructural factors and potential solutions to the physician and nursing shortage predicted to impact the growing US elderly population".
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is limited, reasons include a limited number of teachers, limited funding provided by governments and doctors voting to restrict numbers of medical students. In many countries that do not charge
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Increase the number of medical graduates through increased recruitment of minority students domestically, as well as intensified recruitment of foreign-trained graduates (also known as
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and financial aid to medical students may exacerbate that problem, and low expected pay for practicing physicians in some countries may convince some that the cost is not appropriate.
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has been attributed with increased demand for physician services in many countries, as more previously young and healthy people become older with increased likelihood of a variety of
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Work part-time; in particular, the number working only part-time does not affect the overall number of physicians, but it affects the supply of physician services (e.g. in terms of
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Once trained, the current supply of physicians can be affected by the number of those who continue to practice that profession. The number of working physicians can be affected by:
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Several causes of the current and anticipated shortages have been suggested, but not everyone agrees that there is a true physician shortage, at least in the United States. On the
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Increase use of health care or medical teams (i.e. nurse practitioners and physician assistants) to shift physician workload and allow for increased physician times with patients.
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A number of solutions, including short-term fixes and long-term solutions, have been proposed to address physician shortages. Some have been tested and applied in national
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The demand for physicians is also dependent on a country's economic status. Especially in developing nations, health care spending is closely related to the growth of the
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Additionally, smaller non-profits that work regionally around the world have also implemented task-shifting strategies in order to increase impact. Non profits, such as
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To address physician shortages in high population growth areas in the United States unfreeze the 1996 Graduate Medical Education (GME) freeze/cap instituted by Congress.
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educated community health workers or teachers to perform simple medicinal tasks, thereby freeing up health professionals to focus on more pressing concerns.
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Substitution factors can significantly affect the production of physician services and the availability of physicians to see more patients. For example, an
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Baker RB, Washington HA, Olakanmi O, et al. (July 2008). "African American physicians and organized medicine, 1846–1968: origins of a racial divide".
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Cooper, Richard A.; Getzen, Thomas E.; McKee, Heather J.; Laud, Prakash (2002). "Economic and Demographic Trends Signal an Impending Physician Shortage".
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maternity desert. From 2009 to 2019, there was a 12% reduction in obstetricians delivering babies in Arizona despite a growth in the general population.
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Provide better incentives for physicians to practice in underserved areas – for example, in the U.S., this would include expanding incentives for the
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path and remaining in their country of origin. The number of physicians needed in a given context depends on several different factors, including the
1795: 1142: 112:, are experiencing shortages. Shortages exist and are growing in the United States, Canada, the United Kingdom, Australia, New Zealand, and Germany. 616: 864: 573:
Improve physician wages, such as through privatization of health care systems thereby enhancing market attractiveness for people to become doctors.
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Reduce the costs for students to attend medical school, such as through subsidies for (free or reduced) school tuition and more financial aid.
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Ensure better practice conditions for physicians – for example, medical liability reforms have been cited as an important factor in the U.S.
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to prospective physicians, public funding is the only significant limitation on the number of physicians trained. In the United States, the
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In the United States, to better accommodate the elderly and their demand for healthcare services, increase medical and nursing training in
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Rosenblatt, RA; Whitcomb, ME; Cullen, TJ; Lishner, DM; Hart, LG (September 23, 1992). "Which medical schools produce rural physicians?".
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Improve the political, social and economic conditions in developing countries to prevent brain drain, including fewer wars and conflicts.
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Increase the use of e-mail and telephone consultations, which allow physicians to treat patients seeking more traditional forms of care.
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is one way to address physician shortage, and another is increasing the number of schools, but other factors may also play a role.
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Changes in the specialty balance; for example, in many countries, the balance is shifting away from medical students becoming
1533: 515: 295: 1284: 633: 291:, or other areas in which medical expertise is required, or they may choose a job in which no medical knowledge is required. 988:
Hu, Teh-Wei; Yang, Bong M. (1988). "The demand for and supply of physician services in the US: a disequilibrium analysis".
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organizations helping to provide medical care internationally include Reach Out Worldwide (ROWW), Doctors Without Borders (
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Increased workload and too many patients per doctor resulting in overworked and sleep-deprived doctors, which compromises
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in local health care facilities), the demographics and epidemiology of the population being served, the nature of the
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It has been speculated that politics and social conditions may motivate medical student placements. For example,
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The shortage of obstetricians in parts of the United States has led to coining of the phrase "maternity desert."
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Bodenheimer, Thomas; Grumbach, Kevin; Berenson, Robert A. (25 June 2009). "A Lifeline for Primary Care".
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Improve physicians' perspectives of their future career path, such as though reduced use of temporary
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Anything that changes the number of available physicians or the demand for their services affects the
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per 1000 people to sufficiently attend the basic needs of the population in a developed country.
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http://www.sctimes.com/article/20090726/NEWS01/107260024/1009/Experts-foresee-doctor-shortage
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Charles Phelps, Health Economics (4th edition), (Reading, Massachusetts: Addison-Wesley, 2010
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The demand for physician services is influenced by the local job market (e.g. the number of
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have been cited in some places as preventing some people from enrolling in medical school.
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Cole, A. (9 July 2008). "BMA meeting: Doctors vote to limit number of medical students".
1848:"Rural Areas in Arizona Struggle with Access to Prenatal Care Causing Maternity Deserts" 1231: 180:. The emigration of physicians from lower-income and developing countries contribute to 1929: 1902: 1743: 1583: 1558: 1425: 1398: 1334: 1256: 695: 464: 226: 194: 1230:
Schieffler, Danny A; Azevedo, Benjamin M; Culbertson, Richard A; Kahn, Marc J (2012).
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Nations identified with critical shortages of physicians and other health care workers
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Higher prices for practicing physicians because of less competition by the rules of
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initiatives have limited the available time for direct patient care by physicians.
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Make better use of other categories of health care professionals, including more
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In most countries, the number of placements for students in medical schools and
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Migrate abroad for better economic and social conditions, also referred to as "
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http://sev.prnewswire.com/health-care-hospitals/20081112/CLW00412112008-1.html
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has expanded health insurance coverage and access to an estimated 32 million
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Lower quality of medical care for patients because of shorter doctor visits.
173: 116: 2380: 2227:"How the primary care doctor shortage threatens Obama's health reform plan" 2196: 2086: 1938: 1919: 1592: 1434: 1380: 1372: 1265: 1170:. The Midwestern Office of The Council of State Governments. Archived from 1094: 1053: 548:, which help provide debt-relief opportunities for primary care physicians. 43:
in a country or jurisdiction but also on the number continuing to practice
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Physician shortages have been linked to a number of effects, including:
95:(WHO) estimates a shortage of 4.3 million physicians, nurses, and other 390: 84:
in need of medical care. That can be observed at the level of a given
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Handbook on monitoring and evaluation of human resources for health.
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Approved Medical Resident Hours Still Resulting In Sleepy Doctors
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New-look Inquisitions want to call doctors in for a little chat.
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Models and tools for health workforce planning and projections.
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substitute for legal services by avoiding malpractice suits.
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in rural, urban, and suburban areas experiencing shortages.
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Increase the number of medical schools and classroom sizes.
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The world health report 2006: working together for health.
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Unnecessary patient deaths while waiting for health care.
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and in some places those who leave university without an
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of the local population, the numbers and types of other
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Fail to obtain or requalify for their license or other
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Increasing the number of students enrolled in existing
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Legislate tuition-increase caps for medical schools.
283:; for example, some might choose instead to work in 2252:"Free Salary Information, Personal Salary Reports" 1769: 413:, increasing the demand of physicians, especially 510:, while others remain subject to ongoing debate. 2361:Journal of Public Health Management and Practice 1953:"Doctors from afar meeting rural Oregon's needs" 861:"Medical miscalculation creates doctor shortage" 2278:"Doctors' Salaries and the Cost of Health Care" 2211:Task shifting to tackle health worker shortages 1646:"The Incredible Shrinking Doctor's Appointment" 1312:. Honorary Consulate of Romania. Archived from 1281:"Doctor shortage worsens as student debt rises" 2221: 2219: 420:The Act may have also affected the supply of 401:US Patient Protection and Affordable Care Act 336:, which leads to shortages of physicians for 88:, a province/state, a country, or worldwide. 76:is a situation in which there are not enough 8: 1119:. Wisconsin Healthcare Workforce Development 968:"A debate on what we need our doctors to do" 279:Choose to practice as a physician for their 276:The number of medical school graduates who: 1163:Murphy, Mike; Tim Anderson (October 2008). 1789: 1787: 1392: 1390: 1069:"The metrics of the physician brain drain" 761: 759: 757: 755: 407:Patient Protection and Affordable Care Act 2087:"The Volokh Conspiracy – Doctor Shortage" 1928: 1918: 1781:Posted by Layton Lang, December 12, 2011. 1582: 1424: 1414: 1303: 1301: 1255: 1084: 813: 811: 809: 20:Medical doctors per 1,000 people in 2018. 2021:Association of American Medical Colleges 1870: 1868: 1335:"Shortage of young (white) male doctors" 786: 784: 778:Geneva, World Health Organization, 2009. 617:Association of American Medical Colleges 531:Higher medical school enrollment limits. 332:(GP) because of more attractive pay for 309:Exit the workforce, such as by retiring. 721: 706:Physician shortage in the United States 344:disagree on moral or religious grounds. 2344:: CS1 maint: archived copy as title ( 2337: 2160:: CS1 maint: archived copy as title ( 2153: 1630:: CS1 maint: archived copy as title ( 1623: 1682:Posted by Jill Stark, April 20, 2007. 1462:from the original on 14 December 2019 1448:Rabin, Roni Caryn (21 October 2009). 200:Becoming a physician requires either 7: 1820:Diaz-Hurtado, Jessica (2019-05-20). 1760:2006; 354:1661–1664; April 20, 2006. 1527:"Summary of the Affordable Care Act" 1067:Mullan, Fitzhugh (27 October 2005). 740:from the original on 4 November 2021 2058:"Needs of Patients Outpace Doctors" 2017:"Medicare Resident Limits ("Caps")" 1073:The New England Journal of Medicine 508:health workforce policies and plans 445:Lower quantity of medical care for 1907:International Archives of Medicine 1719:"Sleepy" doctors admit to mistakes 730:"Medical doctors per 1,000 people" 14: 2485:from the original on July 2, 2024 2276:Rampell, Catherine (2008-11-14). 1516:Posted Wednesday, 1 October 2008. 1484:. Knowledge@Wharton. 2009-07-22. 1283:. AllBusiness.com. 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(2005). 1341:from the original on 2019-12-14 1145:from the original on 2016-05-11 949:from the original on 2020-01-09 945:. Toronto: The Globe and Mail. 923:from the original on 2016-12-05 893:from the original on 2011-06-04 867:from the original on 2012-07-25 841:from the original on 2019-02-07 516:International Medical Graduates 63:working in the system, and the 2505:"Our Model: Capacity Building" 1165:"Dropout rates draw attention" 859:Cauchon, Dennis (2005-03-02). 306:The number of physicians who: 137:Supply and demand curves with 99:worldwide, especially in many 1: 2420:"Health:Key Tables from OECD" 1756:Posted by Robert Steinbrook, 1745:Private Health Care in Canada 1115:Burk, Jennifer (2007-05-14). 584:National Health Service Corps 546:National Health Service Corps 349:Demand for physician services 2450:"Countries Without Doctors?" 2426:. OECD. 2011. Archived from 2373:10.1097/PHH.0b013e31819d817d 1875:Bosch, Graham (2019-08-09). 885:Ramirez, Marc (2009-04-18). 455:Millennium Development Goals 268:Number of physicians working 242:American Medical Association 189:Number of physicians trained 2209:World Health Organization. 2056:Girion, Lisa (2006-06-04). 1901:Lakhan SE, Laird C (2009). 817:World Health Organization. 790:World Health Organization. 646:International Medical Corps 2566: 1771:Offshoring Physician Labor 1403:Human Resources for Health 1137:Beene, Ryan (2009-03-18). 941:Feasby, Tom (2009-03-30). 405:In the United States, the 375:chronic medical conditions 129:Economic theory and trends 1879:. Chamber Business News. 1002:10.1080/00036848800000022 837:. Chamber Business News. 711:Primary care service area 621:World Health Organization 544:Increase the role of the 296:professional requirements 202:several years of training 93:World Health Organization 61:health care practitioners 1046:10.1377/hlthaff.21.1.140 634:MĂ©decins Sans Frontières 568:community health workers 379:type 2 diabetes mellitus 415:primary care physicians 206:undergraduate education 105:international migration 1920:10.1186/1755-7682-2-14 1730:Posted by Celia Hall, 1557:Hofer Adam N. (2011). 1373:10.1001/jama.300.3.306 1236:The Permanente Journal 1203:(jul09 1): a748–a748. 438: 411:United States citizens 364:primary care physician 166:gross domestic product 141: 21: 1416:10.1186/1478-4491-3-3 1337:. Sunday Star Times. 970:. KevinMD. 2014-05-15 889:. The Seattle Times. 615:In the US alone, the 479:health care economies 436: 330:general practitioners 321:full-time equivalents 262:gender discrimination 258:Racial discrimination 136: 19: 2509:The MINDS Foundation 2189:10.1056/NEJMp0902909 1086:10.1056/NEJMsa050004 653:the MINDS Foundation 578:employment contracts 560:physician assistants 389:, and some types of 234:clinical internships 215:high school dropouts 101:developing countries 86:health care facility 2430:on February 5, 2015 917:The Washington Post 681:Artificial scarcity 556:nurse practitioners 453:goals, such as the 451:primary health care 334:medical specialists 298:for legal practice. 2282:The New York Times 1777:2018-01-10 at the 1752:2010-02-13 at the 1726:2016-01-29 at the 1700:2016-01-29 at the 1678:2016-03-04 at the 1512:2016-03-03 at the 1455:The New York Times 799:2013-07-29 at the 774:2015-07-01 at the 765:Dal Poz MR et al. 502:Proposed solutions 439: 142: 74:physician shortage 33:health care system 22: 2540:Medical education 2481:. July 20, 2009. 2183:(26): 2693–2696. 2062:Los Angeles Times 1563:Milbank Quarterly 990:Applied Economics 734:Our World in Data 564:clinical officers 493:Maternity deserts 477:in market-driven 475:supply and demand 395:neurodegenerative 146:supply and demand 35:or active in the 2557: 2550:Health economics 2525: 2524: 2522: 2520: 2515:on 9 August 2014 2511:. Archived from 2501: 2495: 2494: 2492: 2490: 2471: 2465: 2464: 2462: 2461: 2452:. Archived from 2446: 2440: 2439: 2437: 2435: 2416: 2410: 2409: 2407: 2406: 2391: 2385: 2384: 2356: 2350: 2349: 2343: 2335: 2333: 2332: 2317: 2308: 2303: 2297: 2296: 2294: 2293: 2273: 2267: 2266: 2264: 2263: 2254:. Archived from 2248: 2242: 2241: 2239: 2238: 2223: 2214: 2207: 2201: 2200: 2172: 2166: 2165: 2159: 2151: 2149: 2148: 2139:. Archived from 2133: 2127: 2126: 2124: 2123: 2114:. 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Index


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