Fewer Physicians Are Practicing Than Previously Estimated

It’s long been an open secret in the healthcare industry that the American Medical Association overstates the number of practicing physicians in the U.S. The main reason is that the AMA Masterfile, which compiles self-reported information from practitioners, includes a lot of retired doctors.

Now the conjecture has been replaced by data in a study just published in the Journal of the American Medical Association. The study found that between 1979 and 2008, there were, on average, 67,000 more active physicians in the AMA Masterfile than the number reported by the U.S. Census Bureau’s Current Population Survey (CPS). The difference between the two databases was almost entirely due to the number of active physicians who were older than 55.

Today, the researchers said, there about 788,000 active physicians in the U.S., about 65,000 less than previously reported.

The CPS also shows there are a higher number of young physicians (ages 25-34) than the Masterfile indicates. This figure is consistent with the number of recent residency graduates, and the number of active older physicians is consistent with the numbers of doctors 55 and older billing Medicare.

According to the study, the CPS data indicates that there will be nearly 100,000 fewer physicians than expected in 2020. Projections based on the Masterfile data estimate a workforce of 1,050,000 physicians a decade from now; but if one uses the CPS data, the estimate is only 957,000, or 9 percent less. And, because there are fewer active physicians over 55 today than had been believed, only 9 percent of doctors will be 65 or older in 2020, rather than 18 percent.

The number of female physicians is increasing, and they tend to keep working longer than men do, according to the study. Another study by the Association of American Medical Colleges, however, found that women physicians are more likely than male doctors to retire after age 55. The AAMC study also suggested that more men would stay on if they could work part time and that one reason for them to keep working is stock market losses that make retirement a less appetizing prospect. So if the market keeps going up, perhaps the trend of earlier retirement will accelerate.

In any case, we are likely to have fewer physicians than anticipated just as expansion of insurance coverage and an aging population are likely to raise the demand for doctors. The silver lining? Female physicians enter primary care fields at a much higher rate than men do. So if the gender mix tilts toward women doctors as men retire, we may be on our way to solving the problem of too few primary-care physicians.