The impending physician shortage has the potential to affect our present and threaten our future. It has been reported that one in three practicing physicians in the United States is over 65 and near to retirement. A lot of the discussion about the physician shortage has centered on primary care. However, it is anticipated that mid-levels can bolster many aspects of primary care and help alleviate physician workloads. Physician assistants and nurse practitioners are taking some of the load of the demands of primary care. Further, a team approach that employs nurse-managed programs can have positive effects on management of adults with chronic conditions such as diabetes and hypertension. The approach can lessen the load of physicians and provide quality of care.

With respect to the physician shortage issues, specialties other than primary care also need to be addressed. Specifically, one specialty that is experiencing a supply and demand crisis is orthopedic surgery. Growing obesity, an aging population, and more active lifestyles are creating a rising need for these services. Clinical oncologists are also worried about how their future numbers will meet patient needs. The number of new cancer patients is expected to grow as the population continues to age, and current cancer patients are living longer and remaining in treatment longer. Although nurse practitioners and physician assistants are important in assisting physicians manage patients and provide care for patients, not just any physician assistant or nurse practitioner can assist specialties or sub-specialties. If they are going to work for oncologists, cardiologists, etc., they will require specialized training.

Although there is not an easy solution to the impending shortage of physicians, the American Medical Association is attempting to address this issue by implementing new policies. They are encouraging federal and state governments and private payers to fund graduate medical education and to increase the number of graduate medical education slots. Methods to train and reward doctors who are part of patient-centered care teams are also being developed.

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