Like the rest of Americans and people around the world, I eagerly awaited the Supreme Court decision on King v. Burwell. The decision, which shifts the direction of the healthcare reform debate, also affirms the demand for physicians, especially family-practice-trained physicians, and other advanced practitioners, such as PAs, NPs, and CRNAs, will continue to skyrocket.
The Association of American Medical Colleges (AAMC) studies the supply and demand of physicians, and indirectly, other providers who perform services in the healthcare system. The most recent report discusses research and findings within the lens of Affordable Care Act (ACA) initiatives and programs having been underway for several years.
The summary essentially reinforces the need to train more physicians, and clinicians such as PAs, NPs, and CRNAs. The ACA has increased the demand for providers at all levels, over previous predictions, and that demand will only continue to grow as more patients continue to enter the healthcare system.
Key findings in the report were as follows:
• The AAMC predicts a projected shortfall between 12,500 to 31,100 primary-care physicians by 2025, while demand for non-primary care (specialty) physicians will exceed supply by 28,200 to 63,700 physicians. This has significant impact especially on PAs, in that we practice in teams with physicians.
• Expanded medical coverage achieved under ACA, once fully implemented, will likely increase demand for healthcare providers, especially those in primary care, by about 2 percent over the current increased demand resulting from changing demographics.
• Due to new data and the dynamic nature of projected assumptions, the projected shortfalls of physicians in 2025 are smaller than shortfalls projected in the earlier study. The lower ranges of the projected shortfalls reflect the rapid growth in supply of clinical providers such as PAs, which have helped to close the gap between physician supply and demand.
• The critical role PAs play in patient care delivery has implications for all providers on the healthcare team. Right now, we cannot train physicians, PAs, and NPs fast enough to meet the demands of the healthcare system.
The AAMC concluded that additional study is needed to determine the impact that providers like PAs have on the supply and demand of physicians. As always, hindsight is 20/20, and the AMCC recognized the limitations and caveats of making predictions about the supply and demand of all members of the healthcare delivery team. Areas of future recommended study included physician retirement patterns, changing wants, needs, and preferences of young physicians, the evolution of clinician staffing patterns, and the effect of payment models.
Speaking for PAs, all of the above areas of future research are important to my profession, especially in the area of retirement. As a growing profession, we are experiencing the first major cohort of PAs approaching retirement. However, as the demand for providers increases, demand for PAs is also skyrocketing due to our rigorous education in the medical model — similar to physicians — and our training in team-based care (on which many new models of care delivery depend).
As PAs practice medicine in nearly every setting and every specialty and subspecialty, our future continues to be tied to the present and future supply and demand challenges confronting our health system. To meet the ever-expanding demand and reflect the realities of today's U.S. healthcare system, it is more important than ever to modernize laws and regulations to allow PAs to practice to the fullest extent of their education and abilities.