Americans make hundreds of millions of trips to the doctor every year, with about 85 percent of adults having some contact with a healthcare professional each year. For kids, the number is even higher (93%).
And for good reason. About 6 in 10 American adults has a chronic condition, like heart disease or diabetes, and 4 in 10 have more than one. Whether it’s for an acute condition like a sinus infection, preventive screenings like mammograms or ongoing care for afflictions like cancer, all those visits have one thing in common — a doctor.
In 2016, there were just under 900,000 active physicians in the United States, with huge variations across the states.
In fact, aside from your income and insurance status, the state where you live may determine how hard or easy it is for you to see a doctor. That’s because in most states, doctors are in short supply, and the situation is only getting worse.
One projection indicates a physician shortage of more than 120,000 by 2030, just over a decade from now. But not all places in the U.S. are in the same shape, as our analysis of doctor staffing and medical education found.
Best And Worst States
To create our ranking of shortages, we totaled each state’s ranking (from best to worst) in the following three areas: the current physician workforce in each state, the percentage of doctors nearing retirement age and the proportion of medical residents nearing the end of their education. The resulting range provides a good idea about which states are most likely to face doctor shortages in the years to come.
For example, while the District of Columbia has by far the highest proportion of physicians and medical students, the district’s percentage of doctors nearing retirement age is relatively high. So D.C. ranks first in the first two categories but 24th in doctors near retirement age (1 + 1 + 24 = 26).
Keep reading after this section to see how the states stack up in each of those measures.
As you’ll learn shortly, most U.S. states currently don’t have high enough staffing levels when it comes to doctors, but several actually have higher than the necessary levels. However, it’s possible that, for instance, Massachusetts, which is tied for the lowest risk, could find itself in a physician shortage based on how many doctors in the state retire and how many new doctors take their place.
More than half of states fall below the recommended level to achieve balance between the number of physicians and the number of residents, meaning there are too few doctors for too many people in most of the United States.
This baseline recommended level changes as the population shrinks and expands, as doctors retire or die and as new doctors finish medical school or relocate to the United States, and according to the U.S. Department of Health and Human Services, not only does most of the U.S. fall below that level but a handful of states are dangerously low on doctors.
As this map shows, 35 states fall below the 283 per 100,000 baseline that is needed to create balance between supply and demand. In fact, the median level falls below that baseline.
A few states currently exceed the baseline level, though, indicating residents of those states are likely to find better physician choice than those in other states. Here’s a look at the top states by how far above the baseline their physician supply levels are.
Nine states fall dangerously below the current baseline, as they lack at least a third of the number of physicians needed to meet the baseline.
With the lowest proportion of doctors to patients in the U.S., Mississippi has less than half the doctors it needs.
A moving target
As the population changes, the number of doctors required to maintain service levels shifts as well. In fact, the number of doctors needed was projected to rise nearly 30 percent between 2000 and 2020.
Because the most recent active physician figures are from 2016, we used the baseline projection calculated for 2015, but let’s explore how the baseline was projected to change.
Note: The numbers in this section reflect the total number of active physicians, including both MDs and doctors of osteopathy, and baseline requirements, which includes doctors involved directly in patient care as well as those who work in areas other than patient care.
Supply And Demand:
The current supply of physicians is just one part of the picture. Every year, doctors retire, leave the profession or die, while new doctors join the workforce whether coming through American medical schools or emigrating to the U.S. from other countries.
In several states, about a third of the physician workforce is nearing retirement age.
The state with the lowest percentage of doctors 60 and older, Utah, still could face a crisis as a quarter of the physician workforce is likely to be retiring in the next five to 10 years.
So which states are in the best position to replace the doctors they’ll lose to retirement? One way of looking at that answer is by examining enrollment in graduate medical education (GME) programs, which is the last step medical students take before becoming licensed to practice medicine.
Every state has at least one GME program, though participation in these programs varies widely across the United States and just because a person does a residency in one state, that doesn’t necessarily mean they’ll go on to practice medicine in that state.
Higher enrollment levels roughly correlates with the presence of well-regarded medical schools. For instance, Massachusetts, home of Harvard University’s top-rated medical school, is second on the list, and D.C., which dominates this report (in a positive way) is home to George Washington University, Georgetown University and Howard University, which all have well-regarded medical schools.
Factors That Strain
The Medical Community
While there are several projections for how bad the doctor shortage could get, almost all projections call for physician supply to fall far short of demand, leading to a shortfall of doctors as high as 121,300 physicians by 2030.
Politics and public policy are factors, too. After all, as more Americans have access to affordable healthcare, which is something a majority of Americans support, they will see doctors more often, leading to greater demand for physicians. In fact, if the U.S. had created healthcare equity in 2016, it would have required at least 31,600 more doctors — that’s 31,000 more than even shortfall numbers.
Policy debates aside, population growth and aging are the primary factors that have created the present (and growing) crisis. There are more people and they are living longer thanks to technology such as medical alert systems meaning that not only do they require more care, but the care they require is likely to become more specialized as they get older.
The physician supply figures we used to calculate the states’ shortfalls were from 2016, just three years ago, but in that time, the U.S. population has gone up by more than 5 million. That’s like adding a population roughly the size of Alabama in just 36 months. In 10 years, the population is expected to surpass 350 million.
As the population gets larger, it’s also expected to get older. The U.S. Census Bureau projects that by 2030, 1 in 5 Americans will be retirement age.
About This Report
This story uses data from several sources to take a widescreen picture of the looming physician shortage that could affect the health of millions of Americans. Where possible, we’ve linked the sources directly within the text, but here’s a recap:
Information on active physicians and their ages as well as enrollment in accredited graduate medical education programs came from the Association of American Medical College’s most recent annual report. Information on the shortfalls and projections in physician supply came from AAMC’s supply and demand report updated in 2018, and the doctor supply baseline and shortage projections were published here by the U.S. Department of Health and Human Services’ Health Resources and Services Administration.
Population information came from the U.S. Census Bureau’s Population Clock and multiple projection publications.
Survey data on public opinion with regard to healthcare came from the Pew Research Center.
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