Shortage of family physicians

While many sources cite a shortage of family physicians (and also other primary care providers, i.e. internists, pediatricians, and general practitioners),^[21] the per capita supply of primary care physicians has actually increased about 1 percent per year since 1998.^[22] Additionally, a recent decrease in the number of M.D. graduates pursuing a residency in primary care, has been offset by the number of D.O. graduates and graduates of international medical schools (IMGs) who enter primary care residencies.^[22] Still, projections indicate that by 2020 the demand for family physicians will exceed their supply.^[22]

The number of students entering family medicine residency training has fallen from a high of 3,293 in 1998 to 1,172 in 2008, according to National Residency Matching Program data. Fifty-five family medicine residency programs have closed since 2000, while only 28 programs have opened.^[23]

In 2006, when the nation had 100,431 family physicians, a workforce report by the American Academy of Family Physicians indicated the United States would need 139,531 family physicians by 2020 to meet the need for primary medical care. To reach that figure 4,439 family physicians must complete their residencies each year, but currently the nation is attracting only half the number of future family physicians that we will need.^[24]

The waning interest in family medicine is likely due to several factors, including the lesser prestige associated with the specialty, the lesser pay, and the increasingly frustrating practice environment in the U.S. Salaries for family physicians in the United States are respectable, but lower than average for physicians, with the average being $140,693^[25] and ranging from $110,000 to $204,000,^[26] but when faced with debt from medical school, most medical students are opting for the higher paying specialties. Potential ways to increase the number of medical students entering family practice include providing relief from medical education debt through loan-repayment programs and restructuring fee-for-service reimbursement for health care services.^[27] Family physicians are trained to manage acute and chronic health issues for an individual simultaneously, yet their appointment slots may average only ten minutes.^[28] Physicians are increasingly forced to do more administrative work, and to shoulder higher malpractice premiums, thus forcing doctors to spend less and less time with patient care due to the current payor model stressing patient volume vs. quality of care.^{[ citation needed ]} Things are starting to change as more insurance carriers consolidate.^{[ citation needed ]} They are not stressing performance but more and more volume, thus increasing insurance company profit margins.^{[ citation needed ]} Physicians are starting to shun insurance carriers to lessen the paperwork in order to focus more on patient care as they are originally trained to do.^{[ citation needed ]}

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