The question of whether the United States is facing a physician shortage is a hotly contested topic. Some projections have estimated a shortfall of between 85,000-200,000 physicians by 2020 but other analysts have suggested that supply is not the issue, rather it is the distribution of physicians both geographically and between specialties that is most problematic. This project proposes to develop an open source projection model that can be used by medical and policy leaders to assess whether current and future physician supplies will meet population health care needs. The model will be intuitive, easy to use, and incorporate numerous parameters that can be adjusted under a variety of scenarios to forecast the supply and demand for physician services at the county, state and national levels. It will accommodate modeling for a wide variety of scenarios including (but not limited to) variations in: rate of growth in demand for care due to newly emerging diseases; the aging population; medicine’s ability to treat more diseases; expanding health insurance coverage; rate of medical school expansions; rate of decrease in physician work hours with the growing number of women in medicine and changing lifestyle expectations among young physicians; effects of new models of care and changing physician employment arrangements; adoption rates of information technologies; rates at which selected roles shift from physicians to other health care discipline as well as role shifts across specialties; and the effect of physicians’ responses to various incentives designed to influence their specialty, geographic location, practice type and clinical practice choices. Our model will build on and update previous models by accounting for the many forces now starting to affect the supply and demand for physicians, by employing more current data and by incorporating clinical and practice-level perspectives. We will not simply generate a static model that, like past models, is closely held as a proprietary product and therefore does not become widely understood, accepted or used. Instead, we propose to create an open-source model to be posted on-line, with wide use encouraged. To promote its acceptance and use, the model will be informed by input from an expert advisory board of clinician leaders from a variety of disciplines and specialties. The model will be transparent and dynamic to allow it to fit as wide a range of future scenarios as possible, so it can be used by practicing physicians in leadership roles in their states and communities, the Physicians Foundation, state medical societies, national and state specialty society groups, public health officials, policy makers and health workforce experts to better understand and debate the effect that different data sources, workforce assumptions and policies will have on physician workforce estimates. Such a model will create a sustainable capacity for the Physicians Foundation to engage with other stakeholders to identify interventions needed to promote an appropriately sized and constituted physician workforce. Further, the model will be designed so it can be easily updated to incorporate the evolving forces that will be affecting the supply and demand for physician services in the future. Final products will include the web-based model accessible to the public via the internet, a user guide, a fact sheet and a final report. The model and findings will be disseminated through presentations at professional conferences, manuscripts, a policy brief and a final report.
Project Director: Erin P. Fraher, M.P.P., Ph.D.
Funding Source: The Physicians Foundation
Total Program Period: 7/1/11-6/30/13