Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The bottleneck in ensuring sufficient primary care physicians

Elaine Khoong, MD
Education
March 3, 2014
278 Shares
Share
Tweet
Share

The past few months I have joined thousands of individuals hoping to match into a residency program in 2014. I have had interviews all over the country and spent way too much time living out of a suitcase.

For many students, residency interview season is exciting. For others, it’s stressful and exhausting. But for me, more than anything else, the interview trail was inspiring.

I am currently applying to internal medicine-primary care programs and saw many of the same students at multiple interviews. In my conversations with other applicants, I was nothing but impressed by what these individuals had accomplished. I met students who had passed legislation, published numerous articles and had done important work domestically and abroad.

Primary care residency spots

In reflecting on the qualifications of my peers, I was saddened when I realized that it is likely that some of us may not match into a primary care program. In the 2013 match, there were 335 internal medicine-primary care positions, which were ranked by 2,165 total applicants. While many applicants also ranked non-primary care-internal medicine programs, there are clearly far fewer spots than interested applicants.

This demonstrates part of the problem in ensuring we have enough primary care providers to meet the needs of an aging, growing and increasingly insured population. The number of graduate medical education (GME) spots is a bottleneck in ensuring sufficient primary care physicians.

In 2010, the Council of Graduate Medical Education advised that the United States increase its proportion of primary care physicians to 40 percent. Simple math shows that the current distribution of residency positions makes this goal unachievable. Out of roughly 30,000 total residency positions in 2013, there are approximately 3,000 family medicine; 6,600 internal medicine; 2,700 pediatrics; and 1,300 obstetrics/gynecology positions. Nearly 90 percent of these residents would need to enter primary care to meet that 40 percent recommendation. In reality, fewer than 50 percent will serve as primary care physicians for any patient.

Thinking beyond increasing the number of providers

It is clear that we are not going to meet the need for primary care providers by training more physicians. For too long, we have tried to beat a dead horse by focusing on how we can improve the supply of physicians. But fortunately, increasing the number of physicians is not the only solution to address a problem that is likely to worsen this year by the influx of insured individuals.

The November 2013 issue of Health Affairs focused on the many other solutions available to address this workforce gap. For example, we can think about increasing the supply of other health care personnel, such as advanced nurse practitioners and physicians assistants. Other ideas include redistributing the patient load and workload to non-physicians, as well rethinking how and where care is delivered. Creativity is going to be required to address the shortage of primary care providers and the many other challenges that face our health care system.

Elaine Khoong is a medical student. This article originally appeared in The American Resident Project.

Prev

An analysis of the Republican alternative to Obamacare

March 3, 2014 Kevin 5
…
Next

The medical industrial complex and the surge of health costs

March 4, 2014 Kevin 6
…

Tagged as: Primary Care, Residency

Post navigation

< Previous Post
An analysis of the Republican alternative to Obamacare
Next Post >
The medical industrial complex and the surge of health costs

More by Elaine Khoong, MD

  • The unintended consequences of the night float rotation

    Elaine Khoong, MD
  • How poor interoperability affects patients

    Elaine Khoong, MD
  • a desk with keyboard and ipad with the kevinmd logo

    When patient-centered care becomes patient-dictated care

    Elaine Khoong, MD

More in Education

  • The role of income in medical school acceptance

    Carter Do
  • Balancing tension and kindness in medical education

    Chloe N. L. Lee, MD, MPH
  • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

    Nandini Erodula
  • A chance encounter in Chicago: lessons in compassionate medicine

    Emily S. Hagen
  • Business education’s role in preventing physician practice decline

    Curtis G. Graham, MD
  • The impact of assumptions on patient communication in medical training

    Esther Covington
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Why patients write: stress relief, self-care, and sharing experiences

      R. Lynn Barnett | Conditions
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Fentanyl Death Trends; Food Additives and Heart Disease
  • What If the Doctor Is Out?
  • Reduced Mortality Seen in Cancer Survivors Who Meet Exercise Guidelines
  • CDC Advisors Endorse Maternal RSV Vax to Protect Newborns
  • Amoxicillin Alone for Acute Sinusitis Holds Up Against Broad-Spectrum Cousin

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Why patients write: stress relief, self-care, and sharing experiences

      R. Lynn Barnett | Conditions
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The bottleneck in ensuring sufficient primary care physicians
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...