Medical school deans and state medical society executives see physician shortages

December 09, 2003

A perception exists among medical school deans and state medical society executives that shortages of physicians exist, particularly in the non-primary care specialties, according to an article published in the December 10 issue of The Journal of the American Medical Association (JAMA).

According to background information in the article, "analyses of trends in health care indicate that, at current rates of production, there will be too few physicians to meet future needs. This conclusion is supported by warnings of physician shortages by some medical specialty organizations and state medical societies as well as by signals from the marketplace, which indicate that young physicians are in greater demand and that patients are having greater difficulty in accessing physicians."

Richard A. Cooper, M.D., from the Medical College of Wisconsin, Milwaukee, and colleagues conducted telephone and Internet surveys with medical school deans and state medical society officials to determine their perceptions about the status of physician supply in their regions and whether, if more physicians were needed, that medical schools could expand. A total of 73 (58 percent) of 126 medical school deans and 44 (86 percent) of medical society executives responded to the survey.

"Of the 70 responding deans from mainland schools, 62 (89 percent) cited shortages of physicians in at least one specialty," the authors report. "Six deans (9 percent) also reported surpluses and 8 others (11 percent) were either uncertain or believed that there were no shortages or surpluses." The authors note that most frequently cited shortages were in anesthesiology (50 percent) and radiology (44 percent). Other medical subspecialties noted for apparent shortages were cardiology, gastroenterology, and geriatrics. Among surgical specialties, shortages were noted in both general surgery (17 percent) and the surgical subspecialties (21 percent). "Shortages within the adult primary care disciplines were cited by 30 percent of responding deans," the authors add.

"The 44 responses from state medical society executives were similar to those of the deans, with 82 percent reporting shortages of physicians in at least one specialty," the authors continue. "Physician shortages in medical subspecialties were cited most often (43 percent); surgical subspecialists were cited by 30 percent and shortages in general and/or trauma surgery by 14 percent. Six other specialties that frequently were cited were anesthesiology, psychiatry, emergency medicine, dermatology, radiology, and neurology, with the shortages in anesthesiology and radiology being characterized as most severe."

"... More than 80 percent of the deans surveyed who commented on the impact of shortages on their schools noted negative effects on faculty recruitment and retention, clinical education, clinical revenues, and related matters." The authors found that there is limited potential for medical schools to expand. "Recent or planned increases in class size were reported by 27 percent of deans and expansion capacity by another 34 percent, but 7 percent noted recent decreases in class size." They add that these changes in class size might be able to produce another 7.6 percent medical school graduates each year.

In conclusion the authors write: "The perceptions of deans and medical society executives concerning physician shortages, coupled with a growing consensus among forecasters about the future demand for physicians, cannot be ignored." (JAMA. 2003;290:2992-2995. Available post-embargo at JAMA.com)
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