AMA sees physician supply tightening in specialty areas

Shortages could grow, and work-force expansion plans must address the maldistribution of doctors and residency positions, medical leaders say.

By — Posted July 11, 2005

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Chicago -- There is a physician shortage out there, according to the American Medical Association, and so far it's limited to specific regions and specialties.

But it's likely to expand, and the number of medical school and residency positions should be increased to address the pending shortage, according to new AMA policy adopted at the organization's Annual Meeting here in June.

"There now appears to be a shortage of physicians," said family physician and AMA Trustee Edward L. Langston, MD. "We want to be part of the solution, and it will take time to determine and assess the need."

The AMA joins a growing number of groups predicting that demand for physician services soon will surpass the supply of doctors available.

While other groups have attempted to quantify the size and scope of this shortage, the AMA decided not to set any numerical objectives.

"Predictions can be very challenging," Dr. Langston said, with work force needs continually changing due to unforeseen population alterations, technological advances and economic shifts.

In the 1980s, many experts, including the Council on Graduate Medical Education, believed a physician surplus was developing, but by 2000 it hadn't occurred because the U.S. population grew faster than expected.

"There may be disagreement with quantitative work-force projections, [but] there is no doubt that shortages exist in at least some specialties and geographic regions," said Sandra Olson, MD, chair of the AMA Council of Medical Education. "Whatever the causes, the AMA must be able to participate in developing the solutions so as to assure appropriate access to care for patients."

Funding sought

The AMA agreed to collaborate with medical school and residency programs to find funds for expansion, such as asking Congress to remove the cap on federal funds for graduate medical education. It also emphasized the need to focus expansion in underserved areas and in undersupplied specialties.

Anesthesiologist Peter Dunbar, MD, an AMA delegate from Washington, said the shortage of physicians in his region of the country was giving other health care professionals the political clout to broaden their scopes of practice.

"The University of Washington School of Medicine is the only one in a five-state area," he said. "We are clearly under-doctored, and as a result the state legislature is expanding nonphysicians' scope of practice."

The AMA's new policy expands on its previous stance taken at the Interim Meeting in December 2004 that regional and specialty shortages within the physician work force exist. It also follows other research anticipating a shortfall, including a 2002 Health Affairs article predicting a need for 200,000 additional doctors by 2020 and a report from the Council on Graduate Medical Education and research from the Assn. of American Medical Colleges that both support a 15% expansion of medical school positions and residency slots.

The AMA also adopted policy to form a multispecialty work group charged with the task of developing solutions specific to physician shortages in emergency and trauma care.

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