How to Fix the Coming Medical Doctor Shortage in the US
A physician shortage is fast-approaching. According to the Association of American Medical Colleges, the US is projected to have a shortfall of up to 121,300 physicians by 2030, owing to population growth and the increased needs of a rising percentage of seniors who will require more doctors. Enter Professor Linda Green, the Cain Brothers & Company Professor of Healthcare Management at Columbia Business School, who has a fix for the looming crisis: increased efficiency.
“There is definitely a reality of a physician shortage in certain geographic areas, particularly rural areas,” says Professor Green, “What I addressed in my research is the conventional way in which prior analyses were conducted was entirely wrong.”
In an article published in Health Affairs, Green and her coauthors identified operational improvements in the delivery of care that have the potential to completely offset the projected increase in physician demand. Green shows how if primary care providers team together in shared practices, they can collectively handle a larger pool of patients. Grounded in mathematics, the proposal is illustrated by a scene at the grocery store’s checkout aisle. If the entire line is handled by one register, then everyone can be held back by one tedious price check. But if one line is handled by multiple registers—as happens at Trader Joe’s, for example—then one delay only delays one person, as the other registers continue to process the line.
Building on this work, Green’s research, Providing Timely Access to Care: What is the Right Patient Panel Size?, found that a pool of three physicians can provide primary care to hundreds more patients than three physicians operating independently, while still assuring timely access. Nationally, if all US physicians pooled into teams of three, and if, in addition, just one in five patient visits received care through an e-visit or from a nurse practitioner or physician assistant rather than from their primary care doctor, then the number of required full-time physicians nationwide drops by one-third, which would resolve the forecasted physician shortage.
