An AOA Critical Issue: Future Physician Workforce Requirements: Implications for Orthopaedic Surgery Education*

Abstract

In 2006, after many months of consideration, the Association of American Medical Colleges (AAMC) recommended that medical schools in the United States increase their enrollment by 30% by 2015 and that residency positions be increased to accommodate the growth in U.S. medical school graduates1. This recommendation is based on the belief that there will be a substantial physician workforce shortage in the future as the economy continues to expand, physicians retire, and patients continue to demand more specialized care. How this prediction will affect the workforce dynamic of orthopaedic surgery and other specialties must be examined carefully. Orthopaedic surgery, like most specialties, has an interest in better understanding how many physicians will be required in the specialty in the future. This is not to suggest that there is one single correct number of physicians in a specialty; in fact, the medical system has proven to be highly adaptive. However, it is in the public's interest to have a distribution of orthopaedic surgeons that promotes high-quality care. Furthermore, it is in the specialty's interest that the number of physicians be sufficient to provide the services that the specialty is best qualified to perform but not so many that physicians are underutilized. Having too few orthopaedic surgeons can lead to access problems for patients and/or to less qualified providers caring for patients with particular problems. Having too many can increase competition, flatten incomes, and reduce procedural volume for individual surgeons and thereby affect quality and outcomes— not to mention possibly increasing unnecessary operations to maintain income levels. Therefore, it is beneficial to both the public and the orthopaedic surgery specialty to have a supply that is close to expected utilization. Achieving balance is easier said than done given the many factors that could influence future supply and demand. One must …