Where Physician Shortages are the Worst

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With the physician shortage looming, patients in some states are becoming ever more susceptible to longer wait times and a decline in outcomes.

Due to the aging U.S. population and the upcoming retirements of older physicians, the nation is currently facing a physician shortage that could have serious repercussions in the future. And with the 1997 cap on Medicare support for graduate medical education (residency programs), a bottleneck was created for the workforce.

But what does Medicare have to do with graduate medical education? You see, medical residents cost hospitals through stipends, salaries, benefits, and institutional overhead costs, and Medicare, through the Direct Graduate Medical Education (DGME) payment system, compensates teaching hospitals for Medicare's share of the costs directly related to the training of residents, but does not may payments related to the education of medical students.

Furthermore, the cost to teaching hospitals of training a resident averages $100,000+ per year, and Medicare will typically only pay around $40,000. Knowing that, there are roughly 110,000 residents in training per year with costs to teaching hospitals coming to roughly $13 billion per year, and Medicare only covers about $3 billion of that. As part of the solution, the U.S. needs to train, at minimum, 3,000 new doctors per year by lifting the cap on federally funded residency training programs.

Key Findings About the Physician Shortage & Supply

According to the Association of American Medical Colleges 2017 State Physician Workforce Data Report, in 2016:

• There were 271.6 active physicians per 100,000 citizens in the U.S., with Massachusetts having the highest density at 443.5 and Mississippi having the lowest at 186.1. The states with the highest physicians-population density are consolidated in the Northeast.
• There were 91.7 active primary care physicians to every 100,000 population in the U.S., with Massachusetts having the highest density and Mississippi the lowest.
• There were 7.8 active general surgeons per 100,000 population. Maine and Vermont had the highest density of surgeons with 12.0 while Utah and Nevada had the lowest with 5.7 and 6.1, respectively.
• 24.5% of active physicians were international medical graduates (IMGs) nationally, but individual states varied. New Jersey and New York had the highest percentage of IMGs with 38.7% and 37.2%, respectively, while Idaho and Montana had the lowest with 5.1% and 5.2%, respectively.
• 34.6% of active U.S. physicians were female. More than 1/3 of active physicians in in 28 states, Puerto Rico, and the District of Columbia were female, and Utah had the lowest percentage of female physicians with 23.8%.
• 30.9% of active physicians were age 60 or older. New Mexico had the highest percentage (37.0%), and Utah had the lowest with 26%.

Interactive Map: Where Physicians Are Needed Most

The following is ordered by which states have the least physicians per 100,000 citizens to the those with the most. Those toward the top of the list are in the most need for new physicians while those closer to the bottom have the most physician-to-population density: