One of the greatest challenges facing nations, like the United States, that are both rapidly growing and rapidly aging is keeping up with the demand for health care services. This month's edition of the Journal of the American Medical Association (JAMA) contains a report issued earlier this summer that indicates that the U.S. could face a shortage of 44,000 primary care physicians by 2025.
The report noted that the number of adults in the U.S. will increase 21 percent by 2025, and the number older than 65 will rise by 73 percent. The researchers calculated that adults over the age of 65 tend to visit their primary care physician about three times a year--twice the rate of those under age 65. The researchers concluded that the number of visits to primary care doctors, as a result, will rise 29 percent by 2025.
On the supply side, the researchers project that the number of primary care physicians will decline five percent by 2025. Dr. Jack Colwill, a professor emeritus at the University of Missouri School of Medicine and the director of the study, noted that the number of generalists graduating from medical school declined by 22 percent over the past decade. Another concern is that a growing number of primary care physicians are sharply reducing the number of patients they are seeing, a trend that could further exacerbate the doctor shortage.
This week's JAMA study is just the latest in a series of reports in recent years indicating that the U.S. is not keeping up with the growing demand for health care workers. This week's edition of Newsweek has a story ("ER Overload")about the overcrowding of emergeny rooms that cites another JAMA study. Dr. Manya Newton, an emergency physician at the University of Michigan and the chief author of tbe JAMA study on the problem, was interviewed for the article. She identified a shortage of primary care physicians as one of the causes of overcrowding in the ER.
Earlier this year, the Institute of Medicine released a report ("Retooling for an Aging America: Building the Health Care Workforce") that raised alarm about a growing shortage of doctors and nurses certified in geriatrics. At present, there are only 7,100 geriatricians (physicians) in the United States - one per every 2,500 older Americans - and less than 1 percent of registered nurses are certified in geriatrics.
While health care coverage for the uninsured has dominated the political debate this year, policymakers at the federal and state levels should also be looking at the future of America's healthcare workforce. The Association of American Medical Colleges, for example, has recommended that medical schools increase their enrollment by 30 percent, but are the policies in place to support that recommendation? And what about the continuing shortage of nurses? Also, an expansion of health care insurance coverage will help more people pay for doctor bills, but will they be able to find a doctor? These and other questions about our future health care workforce need to be answered...soon.
