Growing demand, dwindling supply: The U.S. needs more physicians in rural areas

Six years after projecting that the United States would be short about 94,000 physicians by 2025, physician workforce planning firm 3Dhealth has rechecked its numbers, and the prediction held.

This year 3DHealth compiled "94,000 Short and Counting: Where the U.S. Physician Shortage Stands in 2025," a research refresher of an earlier forecast of the U.S. physician shortage. The company works nationally with hospitals, health systems and physician groups to develop multiyear physician recruitment plans.

Calculating patient needs and physician availability leads to the result: “The country needs more primary care doctors, but it needs faster growth in the specialists who keep an aging population functional. Workforce strategy that focuses exclusively on primary care will miss the 2030 access problem entirely,” the update said.

Specialty gaps still land on primary care physicians, who often must manage patients longer while waiting for referrals, said 3DHealth President and CEO Ron Flower. Independent physicians in small and medium-sized practices, especially in rural areas, are "feeling that pinch the most," he said.

The report found rural America has roughly 71 office-based physicians per 100,000 residents, compared with about 144 in urban areas. By 2040, rural communities will account for more than 60% of the national physician deficit while holding about 14% of the population, according to 3Dhealth. Rural physicians also tend to be older and carry workloads 1.3 to 1.5 times heavier than the national median, so each retirement is harder to replace.

Speaking with Medical Economics, Flower also discussed the states with the largest gaps, including Texas, Florida and Georgia, as well as Plains states such as North Dakota, South Dakota and Nebraska, where shortages top 28% of demand.

For independent practices, he outlined strategies such as competing for physicians and advanced practice providers on autonomy, partnering with local hospitals and health systems, planning four to five years ahead for succession and using advanced practice providers at the top of their license.

"I think there's a lot of opportunity here that's kind of lost in the doom and gloom of one of these reports," Flower said.