The pressures of the last three and a half years have affected every corner of the health care landscape, but nowhere is the effect more evident than the country’s physician workforce. Burnout, staffing shortages, financial challenges, administrative burden, and two U.S. Supreme Court decisions that stand to stifle diversity and representation in medicine have hamstrung physicians across specialties and settings — in rural and urban communities, in hospitals, clinics, and independent practices.
These workforce challenges are compounded by the fact that America — both physicians and our patient population — is also aging, and the number of available doctors is shrinking. Nearly 334,000 health care professionals left the workforce in 2021. Further, the Health Resources and Services Administration estimates that by 2025, there will be a shortage of more than 250,000 mental health professionals, including psychiatrists.
Our patients also experience side effects of this crisis in the form of lengthy wait times, difficulty finding physicians, and even care delays — all which can have negative health consequences. The nation faces a jarring reality: We need more physicians, and we need them practicing in communities that lack adequate access to care. But there are several legal and political barriers to make this a reality.
Our organizations — the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association, and the American Psychiatric Association — represent nearly 600,000 physicians, residents, and medical students across the country. We treat infants, children, adolescents, adults, and seniors. We provide primary care, behavioral health care, reproductive health care, and a variety of essential health services patients seek every day. We form strong relationships with our patients and their families that cement our position as trusted sources of information and leaders in our communities. Because of our unique roles, we are well-positioned to advocate for policy solutions that will ensure we have a robust physician workforce equipped to meet all our patients’ needs.
The road to becoming a doctor in the U.S. is no easy feat. As a first step, we must tackle the steep medical student loan debt that makes a career in medicine unviable for many, and that pushes medical students away from lower-paying specialties, including those who most frequently provide primary care. Medical student debt can significantly affect underrepresented and low-income students and restrict their representation in the physician workforce. This is a trend we cannot allow to continue given that the entire physician workforce significantly lags behind the racial and ethnic diversity of the U.S. population. Black and Hispanic Americans account for nearly one-third of the U.S. population, but just 11% of physicians.
Congress can help us ensure a diverse physician workforce and one that is not laden with the burden of medical student debt by enacting policies that provide student debt relief for physicians serving in high-need roles. We also support legislation like the Resident Education Deferred Interest Act, which allows medical residents to defer their federal student loan interest during their residency. That would save them a significant amount of money in interest they would otherwise accrue and pay back during a time in their careers when their pay is quite low.
Workforce efforts shouldn’t end with graduation — we must make sure physicians are practicing in geographic areas where patients need them the most. We need help in communities where patients must travel far distances to access care, including specialty care. We need help in areas where the physicians are retiring or leaving their practices and where there is not a new doctor ready to take their place. We also need help to ensure that training and payment is sufficient to manage the mental health crisis that is overwhelming our practices.
Policymakers can support and expand programs that have been proven to help address physician shortages and maldistribution in medically underserved and rural areas. This includes funding for the National Health Service Corps and Teaching Health Centers, as well as expanding Medicare Graduate Medical Education slots, which can target specific hospitals and programs in areas and specialties of need.
Additionally, Congress must support policies like the Conrad State 30 and Physician Access Reauthorization Act, which allows foreign doctors studying in the U.S. to remain following their residency in exchange for practicing in medically underserved areas. This closes equity gaps while filling a critical need for quality care in these communities. While expanding these programs won’t entirely fix our workforce shortage, they can strengthen and sustain our nation’s health care workforce.
We have a timely opportunity to reaffirm support and investment in the physician community — the very one that provides preventive and emergency care, takes care of children and families, and helps us respond to emerging and devastating health threats. To Congress and our nation’s health care leaders: We implore you to act now to secure the future of our nation’s health.
Tochi Iroku-Malize, M.D., MPH, FAAFP, is president of the American Academy of Family Physicians. Sandy Chung, M.D., FAAP, is president of the American Academy of Pediatrics. Verda Hicks, M.D., FACOG, president of the American College of Obstetricians and Gynecologists. Omar T. Atiq, M.D., FACP, is president of the American College of Physicians. Ira P. Monka, D.O., MHA, FACOFP, is president of the American Osteopathic Association. Petros Levounis, M.D., M.A., DFAPA, is president of the American Psychiatric Association.