NCPA - National Center for Policy Analysis


May 25, 2010

Under the new health care law, most U.S. residents will be required to have health insurance by 2014.  About 32 million additional people are expected to enroll in some type of health plan.  Evidence suggests that insured people consume twice as much medical care as uninsured people, other things being equal.  This means that 32 million people will try to double their consumption of medical care.  Yet, who will provide that care, asks Devon M. Herrick, a senior fellow with the National Center for Policy Analysis. 


  • According to the Journal of the American Medical Association, there are 778,000 practicing doctors in the United States; just under half of them are primary care physicians.
  • Even before health reform, the Association of American Medical Colleges estimated that an additional 45,000 primary care physicians would be needed by 2020 to keep up with demand.
  • Already, the availability of primary care physicians varies significantly by region and among states: from 0.9 to 1.0 per 1,000 population in many Southern and Western states to between 1.4 and 2.8 per 1,000 in the Northeast.
  • This means there are about twice as many doctors per 1,000 residents in the Northeast than in states such as Texas. 

In response, many medical schools are expanding and four new schools have started enrolling students.  Improving the efficiency of medical education could also increase the supply of primary care physicians.  Still, it is unlikely there will be enough physicians to replace those who retire over the next 20 years.  Moreover, the health reform bill did not include any funds to significantly expand the supply, says Herrick.  

Many physicians are concerned that the quality of care patients receive will suffer if patients are treated by less qualified personnel.  However, when appropriate, some patients may prefer having the choice to receive treatment for minor conditions in a more convenient setting, such as a retail clinic with evening hours, even if it is by someone other than a traditional medical doctor, says Herrick.  

The United States is facing a severe shortage of primary care physicians that will only worsen in coming years.  Using other medical personnel to free doctors from routine tasks might allow physicians to concentrate on those medical tasks for which they are uniquely qualified, says Herrick. 

Source: Devon M. Herrick, "Critical Condition: Primary Care Physician Shortages," National Center for Policy Analysis, Brief Analysis No. 706, May 25, 2010. 

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