The Association of American Medical Colleges last week released updated “post-health reform” estimates of the physician shortage, projecting that the shortages by 2015 will be 50 percent worse than originally anticipated prior to health care reform.

Some key findings include:

• Between now and 2015, the year after health care reforms are scheduled to take effect, the shortage of doctors across all specialties will quadruple. While previous projections showed a baseline shortage of 39,600 doctors in 2015, current estimates bring that number closer to 63,000, with a worsening of shortages through 2025.
• There also will be a substantial shortage of non-primary care specialists. In 2015, the U.S. will face a shortage of 33,100 physicians in specialties such as cardiology, oncology, and emergency medicine.
• With the U.S. Census Bureau projecting a 36 percent growth in the number of Americans over age 65, and nearly one-third of all physicians expected to retire in the next decade, the need for timely access to high-quality care will be greater than ever. [Read more from WSJ Health Blog.]

The findings jibe with a 2009 ACC report on “Addressing the Cardiology Workforce Crisis” that found that by 2020, there will be an inadequate supply of CV specialists to treat the projected 20 million more Americans that will have heart disease by that year. Other findings:

• Currently there is a significant shortage of over 3,000 cardiologists in the workforce.  Only approximately 800 new cardiologists complete fellowships every year in the U.S.
• Forty-three percent of cardiologists in the current workforce are over the age of 55 – nearing the point in their careers that they might consider retirement. 
• There are going to be much greater demands in the next 20 years for cardiology services based on such drivers as population (baby boomers), the epidemic of obesity and the anticipated increase in prevalence of diabetes and concomitant cardiovascular diseases. [Note: This report was drafted before health care reform – and the additional 32 million that will have health insurance under it – was passed.]

ACC Board of Trustees member George Rodgers, MD, FACC, one of the authors of the report, wrote on this blog that in “order to meet the growing demand for cardiovascular services, more is going to have to be done to recruit cardiologists and other nonphysician practitioners to the cardiovascular world.” I feel that the MD shortage points out the need for wide adoption of team-based care in many areas of cardiology – congestive heart failure clinics, coronary artery disease MULTIFIT-like programs (MULTIFIT is a nurse-managed program that promotes lifestyle changes and adherence to medications), cholesterol management, coumadin clinics and more. Our cardiovascular care associates are superb and lead the way for patient-centered team-based care.

Rodgers writes that one way to relieve the shortage is through advocacy, specifically “more government funding for fellowship training positions in general cardiology” and “more funding to train nurses and physician assistants on cardiovascular-specific care.” The federal government, I think recognizing some of the trouble it’s going to have if it doesn’t take action, last week announced $320 million in grants under the health care law, including $30+ million for physician assistant training and $31 million for advanced nursing education, with the purpose of increasing the number of medical residents in high-need fields and opening up opportunities for high-level nursing education.

Although this is a good start, more work is needed to prevent a shortage. As we get closer to the shortage becoming a reality for all specialties (not just cardiology) the government is going to have to take serious steps to make entering the health care workforce, and staying in it, an attractive option.

What do you think the government, or anyone for that matter, could do to help ease the health care workforce shortage?

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