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The Complexities of Physician Supply and Demand: Projections from 2017 to 2032

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The Complexities of Physician Supply and Demand: Projections from 2017 to 2032 i 2019 Update The Complexities of Physician Supply and Demand: Projections from 2017 to 2032 April 2019 Association of American Medical Colleges Washington, D.C. ii This report was prepared for the Association of American Medical Colleges by IHS Markit Ltd.: Tim Dall, Executive Director Ryan Reynolds, Senior Consultant Kari Jones, PhD, Director Ritashree Chakrabarti, PhD, Senior Consultant Will Iacobucci, Senior Consultant IHS Markit Ltd. 1300 Connecticut Ave., NW Suite 800 Washington, DC 20036 © 2019 Association of American Medical Colleges. May be produced and distributed with attribution for educational or noncommercial purposes only. iii CONTENTS EXECUTIVE SUMMARY ................................................................................................................. vii I. INTRODUCTION ....................................................................................................................... 1 II. UPDATED PROJECTIONS ....................................................................................................... 2 Total Physician Supply and Demand ............................................................................................. 4 Primary Care Supply and Demand ................................................................................................ 6 Non-primary Care Supply and Demand ......................................................................................... 9 Medical Specialties .................................................................................................................... 9 Surgical Specialties ................................................................................................................. 11 Primary Care-Trained Hospitalists ........................................................................................... 12 Other Specialties ..................................................................................................................... 13 III. SUPPLY MODELING .............................................................................................................. 15 Supply Modeling Assumptions and Scenarios ............................................................................. 15 Supply Projections ...................................................................................................................... 16 IV. DEMAND MODELING ............................................................................................................. 20 Demand Modeling Assumptions and Scenarios .......................................................................... 20 Summary Demand Projections .................................................................................................... 24 V. EVOLVING CARE DELIVERY SYSTEM DEMAND IMPLICATIONS ........................................ 29 VI. PROVIDERS REQUIRED IF U.S. ACHIEVED EQUITY IN HEALTH CARE UTILIZATION ....... 39 VII. KEY FINDINGS AND CONCLUSIONS .................................................................................... 41 VIII. FUTURE DIRECTIONS IN HEALTH WORKFORCE RESEARCH ........................................... 43 APPENDIX 1: DATA AND METHODS ............................................................................................ 45 Synopsis of Study Methods ......................................................................................................... 45 Supply Model Overview and Updates .......................................................................................... 45 Demand Model Overview and Updates ....................................................................................... 47 APPENDIX 2: PHYSICIAN DEMAND BY PATIENT RACE AND ETHNICITY, REGION, AND METROPOLITAN STATUS ............................................................................................................ 49 REFERENCES ............................................................................................................................... 62 ENDNOTES ................................................................................................................................... 71 EXHIBITS Exhibit 1: Projected Physician Supply and Demand by Scenario, 2017-2032 .................................... 4 Exhibit 2: Total Projected Physician Shortfall Range, 2017-2032 ...................................................... 5 Exhibit 3: Projected Supply and Demand for Primary Care Physicians, 2017-2032 ........................... 7 Exhibit 4: Projected Primary Care Physician Shortfall Range, 2017-2032 ......................................... 8 iv Exhibit 5: Projected Supply and Demand for Medical Specialist Physicians, 2017-2032 ................... 9 Exhibit 6: Projected Medical Specialist Physician Shortfall Range, 2017-2032 ................................ 10 Exhibit 7: Projected Supply and Demand for Surgeons, 2017-2032 ................................................ 11 Exhibit 8: Projected Surgeon Shortfall Range, 2017-2032 .............................................................. 12 Exhibit 9: Projected Supply and Demand for Other Specialties, 2017-2032 .................................... 13 Exhibit 10: Projected Other Specialist Physician Shortfall Range, 2017-2032 ................................. 14 Exhibit 11: Projected Supply of Physicians, 2017-2032 .................................................................. 17 Exhibit 12: Projected Change in Physician Supply: 2019 vs. 2018 Scenario Projections ................. 18 Exhibit 13: Projected Change in Physician Supply by Specialty Category, 2017-2032 .................... 19 Exhibit 14: Projected Demand for Physicians, 2017-2032 ............................................................... 26 Exhibit 15: Projected Change in Physician Demand: 2019 vs. 2018 Scenario Projections .............. 27 Exhibit 16: Physician Demand Implications of Evolving Care Delivery System Components ........... 35 Exhibit 17: Evolving Care Delivery System Implications by Specialty Category ............................... 36 Exhibit 18: Physician Specialty Implications of Evolving Care Delivery System ............................... 37 Exhibit 19: Evolving Care Delivery Scenario and Other Demand Scenario Comparison .................. 38 Exhibit 20: Health Care Utilization Equity Scenario 1, 2017 ............................................................ 40 Exhibit 21: Health Care Utilization Equity Scenario 2, 2017 ............................................................ 40 Exhibit 22: Summary of 2018 and 2019 Report Demand Modeling Data Sources ........................... 47 Exhibit 23: Projected Physician Demand by Patient Race and Ethnicity, 2017-2032 ....................... 49 Exhibit 24: Projected Physician Demand Growth by Patient Race and Ethnicity, 2017-2032 ........... 50 Exhibit 25: Physician Supply and Demand by Census Region, 2017 .............................................. 51 Exhibit 26: Projected Physician Demand by Census Region, 2017-2032 ........................................ 52 Exhibit 27: Projected Physician Demand by Metropolitan/Non-metropolitan Location, 2017 ............ 52 Exhibit 28: Summary of Projected Gap Between Physician Supply and Demand ............................ 53 Exhibit 29: Projected Physician Supply, 2017-2032 ........................................................................ 54 Exhibit 30: Physician Supply Projection Summary by Specialty Category, 2017-2032 .................... 55 Exhibit 31: Projected Physician Demand Summary by Scenarios Modeled, 2017-2032 .................. 56 Exhibit 32: Additional Physicians Required to Achieve Health Care Utilization Equity, 2017 ........... 57 Exhibit 33: Additional Physicians Required to Achieve Health Care Utilization Equity in 2017, by Patient Race/Ethnicity ................................................................................................................ 58 Exhibit 34: Additional Physicians Required to Achieve Health Care Utilization Equity in 2017, by Region ....................................................................................................................................... 59 v Exhibit 35: Additional Physicians Required to Achieve Health Care Utilization Equity in 2017, by Region ....................................................................................................................................... 60 Exhibit 36: Additional Physicians Required to Achieve Health Care Utilization Equity in 2017, by Metropolitan/Non-metropolitan Area .......................................................................................... 61 Exhibit 37: Additional Physicians Required to Achieve Health Care Utilization Equity in 2017, by Metropolitan/Non-metropolitan Area .......................................................................................... 61 vi EXECUTIVE SUMMARY Assessing the capacity of the nation’s future physician workforce is important to give both the public and private sectors the information they need to make investments in optimizing the physician workforce for delivering high-quality health care to the U.S. population. The pace of change in health care necessitates continuously updating and improving workforce projections. Furthermore, shifts in health policy at the national and state levels create uncertainty in plotting a successful course toward achieving major goals. For these reasons, in 2015 the Association of American Medical Colleges (AAMC) made a commitment to commission annual updates
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