PHOTO: Doctor examining patient

A NEW study finds that 35 states, including Virginia, are already below the number of physicians needed to adequately care for their residents, and the doctor shortage is likely to get worse in the coming years.

According to the The Senior List, 283 physicians are needed per every 100,000 residents to maintain a baseline balance between doctor supply and patient demand. Virginia currently has 262.4 physicians per every 100,000 residents, but nearly a third (29.3 percent) of them are over the age of 60 and likely to retire in the next decade.

Only five states (Massachusetts, Maryland, New York, Vermont, Rhode Island) and the District of Columbia currently have physician levels above the baseline. Nine states “fall dangerously below the baseline,” including Mississippi, which already has 52 percent less doctors than is needed for the size of its population, according to the study. Virginia’s doctor-to-patient ratio is between these two extremes.

The study, which examined data from the U.S. Department of Health and Human Services, the U.S. Census Bureau, and the Association of American Medical Schools (AAMC), predicted that the U.S. as a whole will have a shortfall of 121,300 physicians by 2030 as the baseline increases to 291 doctors per 100,000 residents needed to care for a larger and older population with multiple chronic diseases, the major factor driving the looming doctor shortage.

The Virginia Department of Health Professions’ 2008–2030 forecast concurred: “Virginia’s shortage will be primarily among primary care providers and surgeons. The shortage will grow more quickly as the last of the baby-boomers approach retirement age in 2030.” As more aging boomers go on Medicare, they will create more demand for medical services.

“The nation’s population is growing and aging, and as we continue to address population health goals like reducing obesity and tobacco use, more Americans will live longer lives. These factors and others mean we will need more doctors,” Dr. Darrell Kirch, president and CEO of AAMC, said in a statement. “Even with new ways of delivering care, America’s doctor shortage continues to remain real and significant.”

AAMC commissioned an independent analysis of emerging health care delivery trends, such as the use of new technologies, reducing unnecessary hospitalizations and emergency room visits, and using managed care models. They reduced demand for physicians by the year 2032 by only 1 percent. “The magnitude of the projected shortfalls is significant enough that no single solution will be sufficient to resolve physician shortages,” the report noted.

Another factor driving the looming doctor shortage is the “severe bottleneck in physician training” caused by a federal cap on Medicare-funded graduate medical education.

“Because it takes between seven to 15 years to train a doctor, we urge Congress to remove the freeze on federal funding for residency training that has been in place for over two decades without delay,” AAMC stated.

Although medical school enrollment is up 30 percent nationally since 2002, the association points out that while “teaching hospitals incur $18.5 billion in direct training costs each year,” Medicare provides “only $3.8 billion of that total.” Then, once the newly minted physicians are practicing, Medicare pays them less than their actual costs.

If these trends continue over the next decade, privately insured patients in Virginia will have to pick up the rest of the tab while waiting a lot longer to see the doctor.

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