The following pages make the argument that the US does not have enough physicians, hindering access to health care.
The image below from the first of the above pages shows that the US is at the low end of physicians per 1000 people, but at the high end of health care costs as a percentage of income. However, the trend line suggests that the US is an extreme outlier, in that more physicians is associated with slightly higher costs otherwise.
This other image from the same page suggests that the US is not getting its money’s worth from health care expenditures.
The issue may not be the numbers but the utilization and distribution of the physicians we are producing.
To be sure, there are reasons to worry about whether all Americans have sufficient access to primary care doctors. Those warning of a potential shortage are right to highlight our aging, increasingly sick population, and they rightly note that many doctors are cutting back on working hours as they burn out or near retirement age.
Even so, some simple math would suggest that we should have more than enough primary care physicians. By 2025, the Department of Health and Human Services estimates we should have 190,000 non-pediatric PCPs. Assuming normal patient panels (about 2,000), that suggests the capacity to care for 380 million people (vs. a U.S. population estimate of 272 million). Estimates from Ezekiel Emanuel and his colleagues from the University of Pennsylvania published in JAMA in 2017 put the figures even higher — 600 million people, nearly twice today’s population — when adding in all fields related to primary care.*
