A Demanding Supply

Editor's note, October 1, 2007

Predicting future trends based on current readings is often a fallacy. In this month’s cover story “Will There Be Enough Doctors?” we look at a looming shortage of physicians based mostly on some current readings of the industry and the supply of current doctors.

But let’s first be clear that this is really more a story about demand than supply. Last year the Association of American Medical Colleges called for a 30 percent increase in the number of graduating physicians from the nation’s 125 accredited medical schools. There is some academic disagreement over the extent of the predicted physician shortage, but it seems clear that with the spike in medical service demand that will be wrought by the baby boomers, we have a challenge in making sure there are enough physicians to cover them. A subset issue clearly seems to be that the shortage will be exacerbated by a lack of primary-care physicians at the same time the industry as a whole, and Medicare in particular, should be talking about a more dramatic emphasis on primary care and prevention in order to reduce costs.

The larger question, and the one symbolized by the young girl pictured on the cover, is whether being a doctor will continue to be a career goal for the best and brightest in the next decades. What if we follow the assumption that certain current trends will continue? Will the malpractice climate come to equilibrium? Will physicians be pushed toward technical skills at the expense of healing? Will new doctors still be faced with six figures of college and medical school debt before they begin their practices?

But back to the current trends. Is what we are seeing today inexorable? Regional shortages of certain specialties are one current symptom, but whether those spread and become nationally pervasive depends on some X factors that could go either way. While the primary-care physician outlook may seem bleak now, a whole generation of technologically savvy young people may be excited about the future of applying that knowledge to the healing arts in ways that today’s physicians can’t imagine. And we really don’t know for certain which areas of practice that now require a physician may be transitioned to technicians, nurses and other members of the care team as technology improves.

I’m not convinced healthcare leaders are—or should be—treating the physician supply as a disaster preparedness exercise just yet. Staying creative and flexible is the best defense. Hopefully, time will prove today’s predictions to be a misspent warning.

Jim Molpus
Editor
jmolpus@healthleadersmedia.com