Winter Quarter 2012

David L. Jaffe, MS and Professor Drew Nelson Tuesdays & Thursdays   4:15pm - 5:30pm Building 530 - Classroom 127

More Background Statistics

Background

• An aging population: By 2015, the over 65 population will increase by almost 7 million (or almost 18 percent), and people 65 and older use twice as many physician resources as those younger than 65.

• A sicker population: By 2015 US residents (and not just the elderly) with one or more chronic conditions will increase by more than 8 million (more than 5 percent), and people with chronic conditions account for more than 70 percent of physician visits.

• A population with greater active lifestyle maintenance and other care demands: For example, it is predicted that by 2030, Americans will receive eight times as many knee replacements as they are getting today.

• Health care reform: One year after Massachusetts (whose coverage policy is often cited as a model for federal reform) mandated health insurance for all state residents, the number of adults reporting they could not find a primary care provider rose by 75 percent, and long waits for referral appointments (50 plus days for some specialties) are now being reported.

Compounding the problem, the supply of caregivers was not projected to grow fast enough to keep up with demand even without increases in insurance coverage. The number of physicians in the US, for example, although not expected to decline, is not increasing as fast as the demand, and the availability of nurses is actually expected to decline. In addition, the distribution of physicians by specialty is shifting from primary care to other specialties at an alarming rate (a 50 percent decline in the ratio of medical school graduates who selected primary care during the past decade). There are multiple reasons for overall shortages (including medical school capacity, which medical colleges are taking steps to address), but two of the big reasons for shifts away from primary care are money — “… the average primary care physician earns approximately 55 percent of the average earnings for all other non-primary care physician specialties,” — and perceived lower prestige associated with primary care as opposed to other specialties, particularly among physicians.

2015 Predictions

Despite efforts by educational and government groups to increase medical and nursing school enrollment, supply constraints will persist into 2015 and beyond. The declining ratio of primary care physicians will continue unless immediate changes are made to make primary care more appealing.

Supply constraints will inevitably result in more and longer appointment and other care delays, which will feel like rationing to patients and providers. Providers and payers will face public pressure to respond to resulting dissatisfaction.

Updated 11/28/2011

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