OPINION: America, not just New Mexico, is facing a shortage of physicians

Due to an astonishing combination of professional missteps, failed policies and an aging population, America is facing an unprecedented shortage of physicians — one that is putting each of us at increased risk. Although there were some 835,000 practicing doctors in America in 2023, according to the U.S. Bureau of Labor Statistics, we are currently experiencing a shortage because demand exceeds supply.

In 1980, a U.S. government report concluded that American teaching hospitals were graduating too many medical students. It predicted a surplus of 70,000 physicians by 1990. In response, medical schools established what became a 25-year moratorium on increasing class size, enforced by the Association of American Medical Colleges (AAMC) and the American Medical Association (AMA). Yet there was a significant flaw to that initial report: It failed to account for the nation’s rising population, which is now 110 million more than it was 45 years ago. By 2005, as the population grew and the potential for a severe physician shortage emerged, the AAMC and AMA reversed their recommendation, and in the past 20 years, more and more young people have trained to be doctors.

Yet despite the more than 97,900 students in medical school, 38,000 in osteopathic school, and 162,000 doctors currently in residencies and fellowships, the AAMC predicts a shortage of up to 86,000 physicians by 2036. By then, it projects that the U.S. population will have risen 8.4% since 2021. The population of those over 65 will increase by 34%, while the number of people 75 and older will increase by 55%.

It’s not just that we don’t have enough doctors. Part of the problem may be that we don’t have enough of the right kind of doctors. Two-thirds of newly minted doctors are choosing to become specialists, which allows them to earn salaries upwards of twice what a primary care doctor can make.

Even as we struggle to bring more physicians into the fold, another crisis has emerged: more and more frequently, doctors are cutting their hours, seeing fewer patients — or just quitting the medical field altogether. Part of what’s driving this is the growing trend of private equity firms and corporations, such as CVS Health and Amazon, purchasing hospitals and private practices. One major medical group, with about 90,000 doctors in some 2,000 locations across the country, has spent billions of dollars acquiring physician-owned practices, home health centers and surgical centers.

The Physician Advocacy Institute reported that just shy of 80% of all doctors were employed by hospitals or corporations, up 200% in just over 10 years. A 2024 JAMA Internal Medicine report said that 61% of doctors surveyed found private equity ownership unfavorable for health care.

To increase revenue, reduce paperwork and regain control of their lives, many physicians are choosing concierge medicine, a system in which patients pay a yearly out-of-pocket fee in exchange for longer visits and shorter wait times. Costs can range from $2,000 to $10,000 annually. Since most Americans don’t have the financial resources to pay such high and non-reimbursable fees, this further drains the pool of doctors available, especially to older people on fixed incomes.

Despite an aging population, there are fewer than 7,000 geriatricians in the U.S. today. We face a projected shortage of more than 2,000 geriatricians by 2037, according to the Health Resources and Services Administration. Although there has been growth in available geriatric fellowship slots, a substantial number of positions remain unfilled. “There is a perfect storm coming,” says Bruce Scott, M.D., former president of the AMA. “With increased patient complexity, decreased reimbursements and increased demand for prior authorizations from the insurance company. The combination of these makes it increasingly difficult for physicians to accept new patients, and, in some cases, even keep their doors open. We can’t afford to lose even one more doctor.”

The health care system touches all of us: Millions of American workers are currently employed in health care in some capacity, many in government, for insurance companies or in corporate oversight. But in the end, it is often doctors on the frontlines bearing the blame and anguish when diagnoses are wrong or treatments go badly. It’s incumbent upon all of us to understand why our system is in crisis and to support efforts to make it work better for everyone.