The Projected Physician Shortage and Implications for PAs

PAEA Survey Will Help Guide Association’s Response

The issue of a projected medical workforce shortage and how to respond to it was high on the agenda at the 2006 PAEA Annual Education Forum. Keynote speaker Edward Salsberg, director of the Center for Workforce Studies at the Association of American Medical Colleges (AAMC), presented evidence that the supply of physicians in the United States will fall far short of demand by 2020 and discussed policy responses to the shortage, including the AAMC’s recommendation for increasing the first-year enrollment in the nation’s medical schools by 30 percent. At the PA Educators Open Forum session, PAEA President Elect Anita Glicken presented preliminary results of the Association’s recent survey on the expansion plans of PA programs. A detailed report on the outcomes will be available early in the new year.

A Coming Shortage of Physicians

The number of physicians projected to be in the U.S. workforce in 2020 will be nearly 200,000 short of the number needed, Salsberg said. He outlined several key factors that will combine to increase the nation’s demand for health services over the next two decades. These include a rapidly increasing overall population, an increasing percentage of elderly patients (who use proportionately far more medical services than do younger patients), rising patient expectations, and economic growth (increasing numbers of wealthy patients mean higher demand for elective treatments). On the supply side, Salsberg said, the physician workforce is aging, and retirements are projected to exceed new entries to the workforce over the next 20 years.

To combat the projected shortfall, the AAMC has called for a 30% increase in the first-year enrollment of medical schools, but even this will not be enough to meet the demand for medical services, Salsberg said. So a key part of the solution is to work toward a health care system that requires fewer physicians and that bolsters the numbers of other members of the health care team, including PAs.

The PA profession is well positioned to supply much of the needed health care workforce, Salsberg noted. Even if the supply of new PA graduates does not increase, the number of new PAs will exceed the number of retiring PAs by 3 to 1 over the next 30 years. “You have set a path for growth,” he said. [Mr. Salsberg's slide presentation is available at this link .]

PA Program Expansion Plans

To help inform the Association’s participation in national dialogues about workforce planning, PAEA surveyed all PA programs within the last few months. Shortly after Salsberg’s address, Glicken presented some preliminary results of the survey.

The survey found that about half of responding PA programs plan to expand their enrollments over the next five years. The total projected increase for responding programs was approximately 525 students, about an 11% increase over the total 2006/07 enrollment for the 119 programs that responded to the survey. The most common reasons given for the increased enrollment were to accommodate a large applicant pool, to meet a projected regional provider shortage, and to increase revenue for the institution. The most important barriers perceived were a shortage of clinical sites and preceptors, limited classroom and lab space, and limited core and clinical faculty members.

The Association will continue to monitor this issue, Glicken said, and to work with the AAMC and other organizations to develop intelligent responses to the projected shortage of health care providers.