US Primary Care Workforce Growth: A Decade of Limited Progress, and Projected Needs Through 2040
Andrew Bazemore, Stephen Petterson, Kade K. McCulloch
Abstract
BACKGROUND: Despite efforts to mitigate a projected primary care physician (PCP) shortage required to meet an aging, growing, and increasingly insured population, shortages remain, compounded by the COVID-19 pandemic, growing inequity, and persistent underinvestment. OBJECTIVE: We examined primary care workforce trends over the past decade and revisited projected primary care clinician workforce needs through the year 2040. DESIGN AND PARTICIPANTS: Using data from the AMA Masterfile and Medical Expenditure Panel Survey (MEPS), we analyzed trends in the number of primary care physicians (PCPs) and in outpatient PCP visits by age and gender over the past decade. We then used the Medicare PECOS and Physician & Other Practitioners datasets to identify nurse practitioners (NPs) and physician assistants (PAs) in primary care. MEASURES: Using these baseline clinician enumerations and projected population growth estimates from the US Census Bureau for the years 2020-2040, we calculated estimated primary care workforce needs by 2040. KEY RESULTS: The effects of aging and population growth and baseline shortages in the primary care workforce call for significant increases in the primary care workforce to accommodate rising demands. Office visits to primary care clinicians are projected to increase from 773,606 in 2020 to 893,098 in 2040. We project a need for an additional 57,559 primary care clinicians by 2040. CONCLUSIONS: Workforce shortages in primary care continue to expand due to population aging, growth, and heightened rates of clinician burnout & egress.