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Research ArticleOriginal Research

Estimating the Residency Expansion Required to Avoid Projected Primary Care Physician Shortages by 2035

Stephen M. Petterson, Winston R. Liaw, Carol Tran and Andrew W. Bazemore
The Annals of Family Medicine March 2015, 13 (2) 107-114; DOI: https://doi.org/10.1370/afm.1760
Stephen M. Petterson
1Robert Graham Center, Washington, DC
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Winston R. Liaw
2Virginia Commonwealth University, Richmond, Virginia
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  • For correspondence: winstonrliaw@gmail.com
Carol Tran
3University of Virginia, Charlottesville, Virginia
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Andrew W. Bazemore
1Robert Graham Center, Washington, DC
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    Figure 1

    Annual projected number of retiring physicians, by specialty type (2011–2035).

    aIncludes physicians trained in medicine-pediatrics.

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    Table 1

    Estimated Number of Primary Care Physicians, 2010–2015

    Specialty20102011201220132014Estimated 20152010–2014 Annual Change
    Family medicine80,32481,45882,90684,44987,30289,0541,382
    General practice9,5578,9488,0587,5427,2476,668−694
    General internal medicine73,59873,84675,19576,54379,34080,8101,018
    Pediatrics47,76848,04248,82449,71951,14852,016439
    Total211,247212,293214,983218,253225,036228,547
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    Table 2

    Projected Primary Care Workforce Shortages

    YearNeed Supply ShortageAdditional Residents per Year
    Overall: Population Growth, Aging, and InsurancePopulation Growth OnlyCumulative ProductionCumulative Retirement
    2015228,547228,5478,0495,819−2,230
    2020241,291237,46048,29439,5193,9682,196
    2025253,630246,35888,53980,66917,2132,710
    2030264,015254,938128,784119,75626,4401,773
    2035272,887262,897169,029157,97133,2831,700
    • View popup
    Table 3

    Scenarios Projecting the Composition of Additional Residency Slots Needed in 2035

    Primary Care Specialty2015 New Primary Care PhysiciansGIM to FM Ratio
    Proportional to 2015 WorkforceProportional to 2015 ProductionDecreases From Diminished GIM Productiona
    Family medicine3,7681109731,117
    General internal medicine2,4121,486623479
    Pediatrics1,869104104104
    Total8,0491,7001,7001,700
    GIM/FM ratio0.6413.470.640.43
    Change in FM, %2.925.829.7
    • FM = family medicine; GIM = general internal medicine.

    • ↵a GIM comprises 30% of the combined FM and GIM share of additional residents.

    • View popup
    Table 4

    Impact of Retirement Age and Population per Primary Care Physician Changes on Shortage Projections for 2035

    VariableAdditional Residents Needed No. (% Change)Projected Physician Shortage by 2035 No. (% Change)
    Baseline1,70033,283
    Retirement age
     64 y2,427 (43)38,622 (16)
     68 y1,057 (−38)26,835 (−19)
    Population per physician
     10% decrease3,064 (80)60,561 (82)
     10% increase336 (−80)6,004 (−82)

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  • Article in Brief

    Estimating the Residency Expansion Required to Avoid Projected Primary Care Physician Shortages by 2035

    Winston R. Liaw , and colleagues

    Background As the US population ages, grows, and has more health insurance, there are concerns about whether there is a large enough health care workforce to meet demand. This study examines the projected primary care physician shortage through 2035.

    What This Study Found More than 44,000 additional primary care physicians will be needed by 2035 to meet the demands of the US population, assuming current ratios of primary care physicians to population and current physician retirement rates. To eliminate projected shortages, a 21 percent increase in primary care residency production will be needed. From 2015 to 2035, at current production rates, there will be 169,029 new primary care physicians in the US. Because of retiring primary care physicians, however, this production cannot match need, resulting in a shortage of 33,283 primary care physicians by 2035.

    Implications

    • This deficit could be eliminated by adding nearly 2,200 first-year residency positions by 2020, a 27 percent increase.
    • If clinicians begin seeing fewer patients, in keeping with new health care delivery models, the projected shortage would substantially increase.
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The Annals of Family Medicine: 13 (2)
The Annals of Family Medicine: 13 (2)
Vol. 13, Issue 2
March/April 2015
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Estimating the Residency Expansion Required to Avoid Projected Primary Care Physician Shortages by 2035
Stephen M. Petterson, Winston R. Liaw, Carol Tran, Andrew W. Bazemore
The Annals of Family Medicine Mar 2015, 13 (2) 107-114; DOI: 10.1370/afm.1760

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Estimating the Residency Expansion Required to Avoid Projected Primary Care Physician Shortages by 2035
Stephen M. Petterson, Winston R. Liaw, Carol Tran, Andrew W. Bazemore
The Annals of Family Medicine Mar 2015, 13 (2) 107-114; DOI: 10.1370/afm.1760
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