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Physician Need Still Outstrips Rising Supply In California

Cheryl Clark, for HealthLeaders Media, July 26, 2010

The number of physicians in California has been increasing faster than the state's population, but not as fast as the state needs, especially as both state and federal legislation strive to increase the number of people who receive healthcare services.

And though the supply of physicians is increasing, the trajectory may be short-lived as the aging physician workforce continues to cut back on the number of hours worked, retires, or increasingly stops accepting new patients covered by Medicare or Medicaid.  What may be of special concern is that 29% of California’s doctors are older than age 59, more than in other states.  In New York and Florida, 28% and 27% of physicians are age 60 or older, but in Texas only 23% are near retirement. Nationally, 25% are at least 59 years of age.

These findings come from The California Healthcare Foundation’s July edition of Health Care Almanac, which took a snapshot of the physician supply issue as of 2008. Here are some of the findings:

  • California barely meets the nationally recognized standard for primary care physicians, and only Orange, Sacramento and San Francisco Bay area counties meet the mark.  It matches national physician supply numbers, but only because the state has attracted large numbers of specialists.
  • Of the licensed physicians (approximately 127,000 according to the Medical Board of California’s Annual Report) only half of them work full time in patient care.  The rest either treat patients part time, or spend all or portions of their time in research, teaching or administration. About 16% work fewer than 20 hours a week.
  • While 84% of primary care physicians are accepting new patients, nearly half are not.
  • Latinos make up 40% of the population, but only 5% of the state’s physicians listed that background with the California Medical Board.
  • California doctors don’t make as much money as doctors in the nation as a whole.  In fact, for family and general practitioners, compensation was 88% of the national average in 2008.
  • California relies on foreign medical school graduates for a substantial portion of its supply of physicians, especially those who choose primary care.
  • For every 100,000 people in the state, California’s physician supply grew from 245 to 262 between 1998 and 2008.
  • The Inland Empire of Riverside and San Bernardino counties has the lowest number of both primary care physicians and specialists in the state, 40 and 70 per 100,000 population. But counties that make up the San Francisco Bay area have the most, 78 primary care practitioners and 155 specialists.  The recommended supply of primary care doctors is between 60 and 80 and the recommended specialist number is between 85 and 105.

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