For the sake of brevity, I am not going to show my math. Trust me, I’m a doctor! Here are the average panel sizes based on the assumptions above using 2012 census data.
- FP/GP = 1,041 patients per doc
- IM/IM-Peds = 464 patients per doc
- Pediatrics = 552 patients per doc
- Ob-Gyn = 642 patients per doc
- Geriatrics = 1,237 patients per doc (this was tough to estimate, maybe way off)
Take a close look at the patient panel sizes. Yes, they are derived from raw data and don’t represent actual practices, but they do represent every single individual via census data that were represented in the categories that I used. Why are they so much lower than the “average” U.S. primary care doctor patient panel numbers we see quoted so often? The panel sizes would be larger if we count those with more than one doctor, but that would be a wild guess. But, that effect is dwarfed by the fact that I assumed every single American in the age/gender categories that I used has a personal physician, which we know is not the case. There is the issue of uneven distribution of doctors, with more in urban/suburban area compared to rural areas, tending to skew sampling surveys to higher panel sizes. The other sampling bias of surveys may be web presence of the practice. Again, these practices are easier to locate and contact; which might also account for why they have larger patient populations.
So it the physician shortage real? I don’t know. I do know access to supply is out of balance and we can do much better with some efficiency enhancers.
Source: Physician Shortage: An Alternative View by the Numbers | Robert Nelson, MD | LinkedIn
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