Doctor Shortage Is Worsening, Say Hospital CEOs

Physician shortages are much more on hospital leaders' minds these days than shortages of nurses or allied health professionals, a new AMN Healthcare survey of 285 hospital chief executive officers shows. The CEOs doubt there are enough clinicians available to cope with the sharply increased demand for services that healthcare reform is expected to generate.

Ninety-five percent of the hospital leaders said there was a shortage of physicians in the U.S.; 91 percent saw a nursing shortfall, and 86 percent said there weren't enough pharmacists. But the results were different when the CEOs were asked about their own experience. Ninety-five percent said the physician shortage had worsened or stayed the same in the past six months, but 27 percent said the availability of nurses had actually improved. While 52 percent of the respondents ranked the doctor shortage in their communities as "serious," only 20 percent saw the nursing shortage as serious, 14.5 percent viewed the lack of pharmacists that way, and 11 percent regarded the shortage of allied professionals as a serious concern.

The vacancy rate at the CEOs' hospitals was 11 percent for physicians, 5 percent for pharmacists, and 6 percent for nurses and allied professionals. Despite the recession, 25 percent of the CEOs said they had increased physician recruiting efforts. Twelve percent had stepped up recruitment of nurses, 9 percent, of allied professionals, and 4 percent, of pharmacists.

One reason for the increasingly bright picture of nurse recruitment, the AMN survey report suggests, is that whenever there's an economic downturn, older nurses tend to return to the workforce to replenish their retirement nest eggs. However, that doesn't seem to be the case with older physicians. Among the possibilities: either they have enough money to remain in retirement, or more of them are retiring.

Either way, there's going to be a real crunch if healthcare reform legislation, by expanding insurance coverage, drives more folks into the healthcare system. Seventy percent of the CEOs said there are not enough physicians in their areas to meet the increased demand for medical services. Fifty-one percent said there would not be enough nurses; 48 percent said the number of allied professionals would fall short; and 45 percent said the number of pharmacists would be inadequate.

As interesting as these findings would be the answers to questions that were not asked. For example, what did CEOs mean by a "doctor shortage"? Did that include primary-care doctors who no longer come to the hospital, or specialists who rarely do because they're busy in their own offices or ambulatory surgery centers? How much of a difference is there between rural and inner city areas where insurance is poor or nonexistent and suburban areas where many patients have good insurance? And if the physician population has grown faster than the general population, as experts say, why are they still in such short supply?