Taking a Balanced Approach to Workforce Planning

By: Atul Grover, MD, PhD, chief public policy officer, and Lidia M. Niecko-Najjum, JD, RN, senior research and policy analyst, Association of American Medical Colleges

The growing U.S. population is rapidly aging, living longer with more comorbidities, and is using more health care services as it ages – all contributing factors to a physician shortage that is expected to grow to more than 130,000 within the next twelve years.

In one article in the December issue of Academic Medicine, we explain that workforce planning should begin with the current system and continually adjust for patients’ demographic changes and the actual utilization of health care services. In a second article, we argue that anticipated delivery model changes should not be the cornerstone of workforce planning, at least not until there is real data demonstrating that utilization patterns are changing. In an article in the collaborating November issue of Health Affairs, we show that the previous workforce projections have relied too heavily on idealized delivery systems which have contributed to the current shortage of physicians. Today, we should not only plan based upon current utilization patterns but must also take into account the increasing demand for health care services per capita, especially since health care providers are choosing to work less.

The Association of American Medical Colleges recommends that a balanced approach to workforce planning should include efforts to improve efficiency, better coordinate care, and be anchored in prevention. However, it must also include a modest increase in the number of physicians to keep up with population needs—which requires an increase in graduate medical education slots partially supported by Medicare by 4,000 per year. While US medical schools have been on target to increase the number of medical graduates to meet the anticipated demand, Congress has yet to lift the cap on residency slots implemented in 1997. Without more residencies, graduates will be without the mandatory residency training and patients will have less access to physician care at a time when they need it most.

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