Keys to Managing the Physician Shortage: A Focus on Nurses, Efficiency, and Wellness

We've been talking about the physician shortage in the United States for nearly a decade now, but the problem is becoming more acute as the overall population ages faster than we can train doctors. By 2025, we will likely have a provider shortage of anywhere from 46,000 to 90,000 physicians, according to a report by the Association of American Medical Colleges (AAMC). The degree of the shortage is projected to vary by specialty, with surgical specialists experiencing the biggest lack of professionals. The shortage burdens providers trying to fit more patients into the same amount of time, causing burnout for physicians and longer wait times for patients.

Possible Solutions

The AAMC report cautions that the shortage isn't going away anytime soon, and that there is no one solution. Whether it's reliance on technology, creative solutions to patient care, or implementing preventive care to curb illness, dealing with the problem will take input and action from numerous people throughout the industry.

In your practice, though, you can take a few measures in the short term and long term to maintain a positive patient experience and decent work life.

Use More Advanced-Care Practitioners

A widely recommended solution is to increase the use of advanced practice registered nurses (APRNs). Laws vary by state, but there's a general movement across the country to allow nurse practitioners and physician assistants to operate more independently up to the full extent of their license.

To make better use of your time, keep the doctors in your practice focused on complex cases. Allow APRNs to take on more routine cases, and shift as much documentation and paperwork as you can to office staff.

The Institute of Medicine detailed the potential increased responsibility of nurses -- who make up the largest sector of health professionals -- in this shifting industry: "By virtue of their regular, close proximity to patients and their scientific understanding of care processes across the continuum of care, nurses have a considerable opportunity to act as full partners with other health professionals and to lead in the improvement and redesign of the health care system and its practice environment."

You may need to change up workflows or hire new APRNs to make the best use of them, but in the long run, this a great opportunity to keep more patients happy and relieve some of your burden.

Focus on Efficiency

Once you have the best staffing arrangements you can make, work on making the most of everyone's time.

• Evaluate your processes. The American Academy of Family Physicians recommends steps to look at your workflow with an eye toward identifying areas of waste and waiting. Evaluate everyone's job functions. As you rely more on APRNs or increase the role of office staff, you may need to rewrite job descriptions and expectations.
• Take advantage of tools such as online scheduling. One study found that it took an average of eight minutes for a patient to make an appointment by phone, with 30 percent of that time spent on hold. Online scheduling may increase patient satisfaction and save your office staff time for other tasks. Evidence is mostly anecdotal, but it's possible that using online booking can reduce no-shows and cancellations.
• Keep patients healthy. The majority of health care dollars are spent on chronic disease, and poorly managed diseases lead to more office and hospital visits, thereby increasing the burden on physicians. Ultimately, patients should need to see you less often, so leveraging your electronic health record (EHR) data to develop predictive models for recommending screenings or other preventive services to patients is an excellent tactic. By staying ahead of diseases, you can help prevent unnecessary medical visits.

The United States isn't the only nation facing a physician shortage. With an aging global population, many countries have the same struggles. Although you may not be able to address the larger picture, you can take steps to make the effects of the shortage manageable within your practice while continuing to provide quality care.