Health Policy and Management

It is projected that the United States will experience a shortage of 21,100 to 55,200 full-time equivalent primary care physicians by the year 2032. The shortage has been sparked by the passage of the Patient Protection and Affordable Care Act and has continued to grow due to the United States’ aging population, population health initiatives, and physician workload. While primary care physicians are responsible for more than half of all physician office visits in the United States, primary care physicians make up approximately 28% of the workforce. Recently, research has cited compensation as the primary reason for the shortage of primary care physicians. Primary care physicians have historically made less than physicians who specialize in other disciplines. Over the last 10 years, primary care physician compensation has increased. However, the shortage also continues to increase. The purpose of this research is to determine the relationship between primary care physician demand and compensation, and to compare that relationship with other specialties.

Methods: Physician supply and demand data were collected utilizing the Association of American Medical Colleges (AAMC) reports, The Complexities of Physician Supply and Demand. Compensation data was collected utilizing Modern Healthcare’s Physician Compensation database.

Results: When analyzing physician compensation with the employment cost index, primary care physician compensation was 1% higher than projected with inflation. Despite earning more than projected, it was determined that demand has little to no impact on primary care physician compensation.

Conclusions: With more physicians moving towards employment with hospitals and hospital systems, there is an increased need for human resources initiatives. Hospital and hospital systems’ human resources departments should develop initiatives that increase pay for primary care physicians such as the standardization of compensation regardless of specialty within a healthcare organization.Shortages of physicians, especially those within primary care specialties, are at an all-time high and expected to grow. It is projected that the United States will experience a shortage of 46,900 to 121,900 full-time equivalent (FTE) physicians by the year 2032 (1). The fifth annual study conducted by the Life Science division of IHS Markit for the Association of American Medical Colleges (AAMC), The Complexities of Physician Supply and Demand: Projections from 2017 to 2032 (1), also predicts that primary care physicians (PCPs) will account for up to half of the total shortage; resulting in a shortage of 21,100 to 55,200 FTE PCPs by the year 2032 (1). According to the Centers for Disease Control and Prevention’s (CDC’s) 2016 National Ambulatory Medical Care Survey, PCPs were responsible for 54.5% of all physician office visits in the United States (2). Additionally, the use of PCPs results in a higher value of care, better access to care, increased life expectancy, and lower health costs (3,4). However, as of 2017, approximately 28% of the physician workforce were PCPs (1). This discrepancy between the percentage of PCPs in the workforce and the percentage of care that PCPs are responsible for creates a misalignment.

While compensation has increased recently (5), PCPs are often paid least in comparison to other specialties (6). Between the years 2010–2019, family medicine, internal medicine, and pediatric physicians were the three lowest-paid specialties each year with only two exceptions: psychiatry between the years 2013 and 2015 and neonatology and pathology in 2018 (6). With those exceptions, PCPs remained amongst the fourth and fifth lowest-paid specialties respectively (6). Recently, research has cited payment reform for PCPs is imperative to addressing the shortage (7). These claims regarding compensation and the demand for a physician to specialize in primary care are further supported by the law of supply and demandShortages of physicians, especially those within primary care specialties, are at an all-time high and expected to grow. It is projected that the United States will experience a shortage of 46,900 to 121,900 full-time equivalent (FTE) physicians by the year 2032 (1).