title: Primary care physician shortages could be eliminated through use of teams, nonphysicians, and electronic communication.
abstract: Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients' ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns. We show that the implementation of some increasingly popular operational changes in the ways clinicians deliver care-including the use of teams or "pods," better information technology and sharing of data, and the use of nonphysicians-have the potential to offset completely the increase in demand for physician services while improving access to care, thereby averting a primary care physician shortage.
authors.affiliation: Columbia Business School, New York City, NY, USA. lvg1@columbia.edu
authors.forename: Linda V
authors.initials: LV
authors.lastname: Green
authors.forename: Sergei
authors.initials: S
authors.lastname: Savin
authors.forename: Yina
authors.initials: Y
authors.lastname: Lu
mesh_terms: D001071:Appointments and Schedules; D003198:Computer Simulation; D057286:Electronic Health Records / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D009722:Nurse Practitioners / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration*; D010823:Physician Assistants / Q000458:organization & administration*; D058007:Physicians, Primary Care / Q000600:supply & distribution*; D014481:United States