Physician work force estimates far apart

All the projections point to a shortage, but none agree on the size.

By Myrle Croasdale, AMNews staff. June 20, 2005.

There's a prediction that a physician shortage looms, but experts disagree on how deep the shortfall will be.

The latest in a line of physician work-force projections comes from the Health Resources and Services Administration's Bureau of Health Professions, which anticipates a shortage as small as 51,000 physicians to as many as 228,000 physicians by 2020.

The Council on Graduate Medical Education earlier projected an 85,000-physician shortfall by 2020, while a study published in the 2002 January/February issue of Health Affairs predicts a 200,000-doctor shortage by 2020.

So why are the numbers so far apart?

Supply and demand factor in, but in the simplest terms it comes down to this: How many physicians are needed to prevent significant disruptions to the health care delivery system? That ratio of physicians to patients is somewhat subjective.

For instance, a researcher could decide that the number of physicians in Maryland relative to the population during 1960 was about right and project that ratio forward as the population grows, according to economist Thomas Getzen, PhD, executive director of the International Health Economics Assn. who co-authored the 2002 estimate in Health Affairs with Richard Cooper, MD, director of the Medical College of Wisconsin's Health Policy Institute.

"Since there is no real definition or measurement that everyone agrees on, you'll always have numbers all over the map," Dr. Getzen said.