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BFMV Perspective: The Physician Shortage, Patient Access, and FMV

Major access to care issues in the US, stemming from a physician shortage, have been a looming concern since the early 2000s. Deficits are projected to be in the range of 50,000 to 150,000 physicians by the mid-2030s due largely to the aging patient population and physician retirement trends. The COVID-19 pandemic is believed to have exacerbated the issue by contributing to provider burnout and accelerating physicians’ plans to retire or transition out of clinical practice.

In the fall of 2023, The Association for Advancing Physician and Provider Recruitment (AAPPR) addressed the impact of the increasing US physician shortage on physician recruitment in its annual Internal Physician and Provider Recruitment Benchmarking Report. The AAPPR reported that healthcare organizations are attempting to recruit higher numbers of physicians than ever before amid historic labor shortages.[1] The report, which provides industry data to help in-house recruitment professionals in workforce planning and growth management, found that active physician searches per year have more than doubled since 2017. Data also show that 2022 marked the fifth straight year in which the percentage of completed searches decreased, as the demand for physicians remains competitive and labor remains scarce.

 

BFMV has written previously on the effects of the physician shortage

on the number of moonlighting arrangements we see in our work.

 

The shortage is expected to affect all specialties, with primary care being an area of significant concern. A September 2022 report from the Kaiser Family Foundation noted that 97.6 million people in the US live in a designated primary-care health professional shortage area (HPSA), and more than 16,900 practitioners are needed to remove the HPSA designation.


According to a 2022 article from the American Medical Association (“AMA”), there are at least three ways to overcome the physician shortage:

1. Increase the number of residency positions, which requires increased Graduate Medical Education (“GME”) funding.

2. Increase the use of technology solutions to provide access to physicians, improve physician oversight, and increase documentation efficiency.

3. Increase and support the use of physician-led team-based care.


It is interesting to note that some observers approaching this issue from a business perspective have wondered publicly if the felt physician shortage is an impetus to revolutionize healthcare. Expanding on the three AMA recommendations, a business management article from the Harvard Business Review (“HBV”) argued that the problem of patient access to healthcare isn’t a shortage of doctors in the US but rather an antiquated system of operations within and around physician services. HBV suggested that creative solutions to uneven geographic distributions, insufficient insurance coverage, inflexible care models, payer aversion, and inefficient use of physician labor could overcome the process relics that have resulted in a shortage. Using adult primary care as an illustration, the article asserted that our current theoretical capacity (380 million non-pediatric patients) is more than adequate to serve the needs of the current potential patient population (US adult population of 272 million).


Ultimately, the stormy sea of healthcare is roiling, and decision-makers are facing real tests of resourcefulness in recruitment, retention, employment, and contracting with physicians. BFMV has extensive experience navigating the waves of economic and compliance realities and supports health systems with compensation consulting and FMV opinions for physicians nationwide. Contact us for more information about establishing fair market value compensation for all types of physician compensation arrangements.

[1] More than 150 member health organizations of AAPPR participated in the extensive annual research study, representing more than 19,000 searches, 60 percent of which were specific to physicians. The Bureau of Labor Statistics (BLS) projects about 24,200 openings for physicians and surgeons each year, on average, over the decade, meaning the data from AAPPR’s Benchmarking Report represents close to half of all physician searches in the United States.

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