It is well established that the country faces a severe physician manpower shortage, which will only worsen as health insurance coverage is expanded under the Affordable Care Act and the baby boomers continue to reach retirement age. Overall, the shortage will approximate 130,600 physicians by the year 2025 — 64,800 specialty physicians and 65,800 primary care physicians.
To illustrate the problem, the Association of American Medical Colleges (AAMC) recently released a motion graphic, which explains the physician shortage issue and the policy behind the growing shortage of residency positions for medical school graduates. This motion graphic is embedded at the bottom of this post, and we encourage folks to watch it, as it provides an excellent depiction of the physician shortage and the need for Congress to increase the number of federally funded residency training positions.
To put the physician shortage issue into perspective for neurosurgery, right now there are about 3,689 practicing board certified neurosurgeons for over 5,700 hospitals in the U.S., serving a population of more than 311 million people. As the population ages and more of our citizens face debilitating and life threatening neurological problems such as stroke, degenerative spine disease, and Parkinson’s and other movement disorders, this supply-demand mismatch will become even more acute. A recent study published in the journal Health Affairs confirms the dire shortage of neurosurgeons. The authors of “An Aging Population And Growing Disease Burden Will Require A Large And Specialized Health Care Workforce By 2025,” estimate that demand for neurosurgical services will increase by 18 percent, and market indicators such as long wait times (nearly 25 days) to obtain non-emergent neurosurgical appointment, suggest that the current supply is inadequate. Furthermore, to add insult to injury, unlike primary care and other specialties, the pipeline for becoming a board certified neurosurgeon is long — as much as 18 years from the start of medical school to certification — so replenishing the neurosurgical workforce is no easy task.
Fortunately, there is hope on the horizon, earlier this year, Reps. Aaron Schock (R-IL) and Allyson Schwartz (D-PA) re-introduced H.R. 1201, the Training Tomorrow’s Doctors Today Act. The bill currently has 49 co-sponsors. Additionally, S. 577, the Resident Physician Shortage Reduction Act, was also introduced in the Senate by Sens. Bill Nelson (D-FL) and Charles Schumer (D-NY) and has ten co-sponsors. The companion bill, H.R. 1180, was introduced in the House by Reps. Joseph Crowley (D-NY) and Michael Grimm (R-NY) and has 73 co-sponsors.
Capped in 1997 by the Balance Budget Act, these pending bills would increase the number of Medicare supported residency positions by 3,000 each year for the next five years for a total of 15,000 new residency slots. One-half of these positions are required to be used for shortage specialty residency programs, of which neurosurgery qualifies.
The looming physician shortage is an avoidable crisis and Congress should take action now to eliminate the current GME funding caps, expand funding for the full length of ACGME accredited training, maintain current financial support for children’s hospital GME and encourage all other payers to contribute to GME programs. And, at the end of the day, an appropriate supply of well-educated and trained physicians – both in specialty and primary care – is going to be the most essential element to ensure access to quality healthcare services for all Americans.
Graduate Medical Education and the Physician Workforce from AAMC on Vimeo.
