Meeting the Medical Needs in Shortage Areas
Lucio N. Margallo II, MD
President, South Dakota State Medical Association
August 3, 2022
According to Association of the American Medical Colleges (AAMC) projections, the U.S. will face a potential physician shortage of close to 39,000 to 120,000 over the next 12 years.
During the past 50 years, I have volunteered and devoted considerable hours to help educate and train medical students and residents, physician assistants, nurse practitioners, nurses, athletic trainers, and medical assistants coming from colleges and universities all over the world including the U.S. Many of them have moved on to become successful practitioners in their fields in rural South Dakota and all over the country. It was a small contribution that was made in the hope also of helping to solve the shortage of healthcare professionals.
American Medical Association (AMA) Past President Gerard Harmon, MD, during an interview in April, said that because it can take up to a decade to properly educate and train physicians, we need to act now to ensure that we have enough doctors to meet the needs of tomorrow. Indeed, the health of our nation depends on it. AAMC projections indicate that by 2034, the shortfall will be 17,000 to 17,800 in primary care and 21,000 to 97,000 in non-primary care. It has also been projected that during the next 10 years, the U.S. population will grow 10.6 percent, and the 65-plus population will grow up to 47 percent; whereas about one-third of actively practicing physicians will be more than 65 years old and reaching retirement age.
The physician shortage is also confirmed by data from the U.S. Health Resources and Services Administration (HRSA) and the U.S. Census Bureau. The current U.S. population of 331.5 million is projected to grow to 364 million by 2034. On the other hand, the total physician supply would increase from 808,400 in 2019 to 857,700 by 2034 – a 6.1 percent increase, which is below the approximately 10.6 percent projected growth in the U.S. population over the same period, thus contributing to a 4 percent decline in the physician-to-population ratio (declining from 246 to 236 physicians per 100,000 population by 2034). The shortfall could cost thousands of lives per year. On a positive note, increase in primary care physicians is associated with lower cause-specific mortality.
Major contributing factors to the shortage issues are:
1. Growth of U.S. population
2. Aging population
3. Aging physicians, retirements, and burnouts
4. Medical education and residency quota
5. Immigration laws relating to exchange students and J1 visa requirements (could the problem in shortage areas be addressed by international medical graduates?)
Therefore, as citizens and physicians, we should strongly support certain solutions to overcome the physician shortage as advocated by AMA, such as:
1. Physicians' wellbeing and awareness of their mental health
2. Removal of obstacles to care such as prior authorization
3. Easing the financial burdens and debts of young doctors
4. Bipartisan resident education (Deferred Interest Act)
5. Increasing the number of residencies
6. Wider use of medical technologies
7. Supporting physician-led team-based care.
The South Dakota State Medical Association and the AMA are our strong and powerful allies. Let’s work together.