Too many patients, not enough doctors

The Affordable Care Act has sparked plenty of heavy disagreement and debate, including about what its true cost might be, how the system can deliver better care while reining in costs and even whether Congress has the right to draft such legislation in the first place.

But even with all those questions, one has received little notice: Will we have enough health care professionals to handle a growing and aging population?

According to a new study performed by economic forecasting consultancy IHS for the Association of American Medical Colleges, the answer is no. By 2025, it foresees a shortage of between 46,000 and 90,000 physicians, with specialists being the hardest to come by. The problem is basic supply and demand. A growing population, with a large aging segment, is growing faster than the minting of new doctors. The expected result will be a shortfall.

The study determined that size of shortage after looking at projections for service demand, demographic changes and alterations in payment mechanisms and processes. The quick summation is that demand will outstrip supply.

  • Even though the number of physicians will "modestly" increase by anywhere from 4 percent to 12 percent, the difference in actual physician availability depends on future retirements and number of hours doctors work.
  • The growth in physicians won't keep up with increased need, which could rise by between 11 percent and 17 percent. That includes Census Bureau revised projections of a U.S. population of 347.3 million by 2025.
  • The shortfall in primary care physicians could run between 12,500 and 31,100. For nonprimary care physicians (specialists), the shortfall will run between 28,200 and 63,700.
  • Although the ACA is expected to increase demand for physicians because more people will have access to health insurance, those patients represent only a 2 percent increase of demand over supply.

To reduce shortfalls to the lower ends of the ranges, the health care system will need multiple strategies to offset the lack of doctors. Among those are improved technology and greater dependence on physician assistants as nurse practitioners, certified nurse midwives and nurse anesthetists.