Almost 500 people move to the Metroplex every day. Census data backs it up, and if you pull the lens back to look at the entire state of Texas, we are growing in a big way – 29 million at last count. It won’t be long before we overtake Chicago as the 3rd largest metropolis in the country. Change is coming with this type of growth. Big D is getting bigger, and older.
Projections show that by 2030, Texans over the age of 65 will more than double since the last census in 2010. With age, comes the need for more frequent doctor visits and the need for more access to specialists. For now, we have a plethora of choices when it comes to our healthcare providers, but the wait times will begin to get longer. What once was an adequate number of physicians in the Metroplex will pale in comparison to the growth and age of our population.
It’s no secret that the physician shortage has impacted the rural areas of Texas and every other rural area in our country for more than a decade. Now, facilities in metropolitan areas like DFW are feeling the effects of the shortage. The Association of American Medical Colleges published its 2017 version of the report titled, The Complexities of Physician Supply and Demand, which predicts a shortage of 34,000 to 88,000 physicians by 2025, increasing to 40,000 to 105,000 by 2030 in the United States.
When the report was released in 2008, many of us felt the issues and implications sited were problems for a distant future, but now, 2025 is a short six years away. The impact of this very real shortage is already here. Many private clinics in the DFW area struggle to compete with hospital-based positions and have openings going unfilled. It may be a few years before patients will feel this, but our healthcare providers are already feeling it with increased patient volumes. I could write an entire article on physician burnout due to high volumes and the complexity of reimbursements, but we’ll have to save that for another time.
Key Contributing Factors of the Physician Shortage
- Population Growth – The U.S. is the 4th fastest growing country in the world. A recent US News and World Report article showed that the U.S. grew by 2,307,285 from 2017 to 2018. In the same article, the top 10 states by population growth were listed. These states are significantly outpacing the 12% expected overall growth. Texas is on the list!
- Aging population – Over the next 12 years, we will see a 55% increase in our population over the age of 65 as our “Baby Boomer” generation enter their golden years. Two-thirds of Americans over the age of 65 have at least one chronic illness and 20% of them see 14 physicians regularly. The subsequent increase in utilization/demand will undoubtedly exacerbate the staffing shortages. Keep in mind, our physician population is aging too, with more than 25% of practicing physicians over 60 and likely to retire within 10 years.
It’s a myth that we don’t have enough students going into medical school. We have quality students graduating medical school that don’t match to a residency, due to the lack of available residency slots and the limited number of available programs. The Balanced Budget Act of 1997 imposed caps on the number of residents teaching hospitals are eligible to receive.
We also have bottlenecks with immigration for physicians. Even though we have almost a million people immigrate to the U.S. every year, visas for physicians are limited. While it may seem bleak, solutions are being worked locally and nationally.
Sam Houston said, “Texas has yet to learn submission to any oppression, come from what source it may.” We are resilient and innovative, two qualities that will see us through the looming shortage. Innovations in healthcare delivery, like significant expansions in telemedicine, are quickly growing to bring virtual specialists into our underserved areas. Technology and new ways to deliver care will be a huge part of the solution as will continued growth of the nurse practitioner and physician assistant population.
Dallas, home to some of the best medical facilities in the country, and is also home to every major physician staffing firm in the country. I’m betting that we will make Sam Houston’s words ring true yet again.
David Fontenot is the President, CEO, and co-founder of Adaptive Medical Partners, a physician recruitment service.