Health reform's expansion of insurance means doctor shortages are about to get worse

Doctor shortages are most chronic in rural America, but now even places with growing populations like Southern California's Inland Empire are feeling the considerable pinch of not having enough doctors to provide care for a growing number of patients. Thus, some medical crises that face California's Riverside County or suburban Phoenix mirror those found in places like the Mississippi Delta, where there are too few specialists, too few doctors willing to take Medicaid and all are overworked because 9 percent of the nation's doctors take care of 20 percent of the country's population, report Annie Lowrey and Robert Pear of The New York Times. (NYT chart)

The problem is expected to spread under federal health reform, they write. With the expansion of insurance coverage and aging baby boomers driving up demand, "The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. That number will more than double by 2025," Lowrey and Pear report. "Even without the health-care law, the shortfall of doctors in 2025 would still exceed 100,000." In addition, Medicare officials predict their enrollment will surge to 73.2 million in 2025, up 44 percent from 50.7 million this year because of the baby boomer demographic hitting their golden years. “Older Americans require significantly more health care,” said Dr. Darrell G. Kirch, the president of the medical-college association. “Older individuals are more likely to have multiple chronic conditions, requiring more intensive, coordinated care.”

Medical-school enrollment is increasing, but not as fast as the population. The number of training positions for medical-school graduates is lagging. Younger doctors are on average working fewer hours than their predecessors. And about a third of the country’s doctors are 55 or older, and nearing retirement. (Read more)