Physician Supply Projections

FTE supply projections provide a more accurate picture of the adequacy of supply (than do projections of active physicians) because the FTE projections consider the decrease in average hours worked as the physician workforce ages and women constitute a growing proportion of physicians. ^[8] The estimated number of physicians in clinical practice (which excludes residents and physicians primarily in non-patient care activities, increases from approximately 635,800 in 2005 to 719,800 by 2020 (Exhibit 12). FTE supply of physicians engaged primarily in patient care activities (including residents) grew from approximately 714,000 in 2000 to approximately 764,000 by 2005 (Exhibits 13, 14, and 15). Although total physicians engaged primarily in patient care grew by approximately 56,000 between 2000 and 2005, the estimated decrease in average hours worked suggests that during this period the net increase in total patient care hours was equivalent to only 50,000 physicians. By 2020, FTE physicians engaged primarily in patient care is projected to reach 866,000 (a 10 percent increase from current levels).

*Includes MDs and DOs. Residents are not FTE-adjusted. Specialties are grouped to agree with those groupings shown in the projected requirements tables, Exhibits 30 and 32. Physicians age 75 and older are excluded.

Note: Totals might not equal sum of subtotals due to rounding. Specialties are aggregated to be comparable to the specialty categories from the Physician Requirements Model (see Exhibit 30).

  [D]                                                                                                       [D]

  [D]                                                                                                     [D]

 [D]                                                                                                    [D]

Total active, patient care physicians is projected to increase to 891,000 by 2020, but the number of FTE physicians is projected to increase to only 866,000 (Exhibit 18). Under the assumption that physician productivity increases by 1 percent annually (e.g., through improved training, technological advances, and increased use of other health professionals), by 2020 the actual physician supply would be equivalent to approximately 1,057,000 physicians (in comparison to year 2000 physicians).

The PSM can also be used to project supply under alternative United States medical school output scenarios. As shown in Exhibit 19, if medical schools could instantaneously increase the number of graduates by 10 to 20 percent, the impact on physician supply by 2020 would be approximately 30,000 to 60,000 additional physicians.

While the future national supply of physicians is relatively straightforward to project in the aggregate, projections by medical specialty are more difficult to calculate because a large number of factors influence specialty choice. Furthermore, the number of medical school graduates has been relatively constant over the past two decades while the number of physicians choosing a particular specialty can vary substantially from year to year.

If specialty choice trends from the late 1990s and early 2000s continue, the number of FTE physicians in primary care specialties will grow approximately 18 percent between 2005 and 2020, compared to a growth rate of 10 percent for non-primary care physicians. There appears to have been a swing back towards specialization in the past few years, reflecting the dynamic nature of specialty choice.

The PSM attempts to capture the major trends affecting physician supply but is a relatively simple representation of the millions of supply-related decisions physicians and the institutions make that affect physician training and practice. Like all projection models, the accuracy of the projections diminishes with the time horizon such that short-term projections are likely more accurate than longer-term projections. Similarly, projections for broader categories of medical specialties are likely more accurate than projections for narrowly defined medical specialties. Furthermore, many physician specialties have overlapping scopes of practice that blur the distinction between individual related specialties.