Thursday, January 12, 2017

We're Doomed Dep't: Now Docs In Their 60's Outnumber Those In Their 30's (Updated With Some Good News)

I cannot make this stuff up (PDF, see the 2014 population statistics on p. 4). I have written about this before; the insane problems of new physician minting will not go away, and apparently are not being attended to, titular but comically small efforts notwithstanding. In two years, about thirty thousand doctors entered their sixties, i.e. near retirement age, while physicians in their 30's actually diminished, both in absolute population and as a percentage of the overall population. The problems of healthcare costs can not be properly addressed until we get the physician shortage addressed.

Update 2017-01-14: Last night, in a Facebook conversation Jerry Thornton made the point that the headline good news was a 4% increase in the overall physician population from 2012 to 2014. It's useful to do some quick checks to make sure this is of significant import relative to the larger problem, i.e. that of overall physician-to-population ratio. From my earlier work, the OECD average is 30.6 physicians per 10,000 population, or 3.06x10-3, expressed in scientific notation. How long will it take to get the US from where it is to there?
  • 2012 estimated US population: 314 million. (Population is only known precisely in census years, but is estimated between them. Source page here.)
  • 2014 estimated US population: 319 million. (From the same source above.)
  • OECD most recent year physician-to-population ratio: 3.29x10-3 physicians/population. (It's actually gone up.)
  • US most recent year physician-to-population ratio: 2.56x10-3 (from the prior link)
  • US physician population, 2012: 878,194
  • US physician population, 2014: 916,264
 Let's find the annual physician growth rate first.

916 264 = 878 194(1+x)2

Solving for x, the annual physician population growth rate, gets us

x = sqrt(916 264/878 194)-1 = 2.14x10-2

Now, the general population is growing at the same time. How much? Let's do the same math:

p = sqrt(319/314)-1 = 7.93x10-3

So when will these converge at the OECD average of 3.29x10-3 physicians/population? (I ignore the growth in the OECD average physician-to-population ratio.) Note that the Journal of Medical Regulation census physician population divided by the US Census general population figure gives us 2.87x10-3, which is higher than the OECD physician-to-population figure; we'll use that as a basis anyway, as both numbers are presumably more up-to-date, and won't make much of a difference relatively.

916 264 physicians * (1+2.14x10-2)n/3.19x108 population * (1+7.93x10-3)n = 3.29x10-3 physicians/population

Solving for n, the number of years until the US meets the OECD average physician-to-population ratio, we get 10.5 years, which is pretty fast as these timelines go. However, given OECD physician-to-population ratios are rising (almost certainly in response to population aging), it's probably somewhat misleading.

Update 2017-01-15: Even more interesting: feet-on-the-ground physicians vs. state populations for the 50 states ratio is 385 physicians per 100,000 population, which puts the US in the upper half, at least, and maybe the upper third. This makes me wonder about the OECD methodology; do they count expats in the denominator?


  1. Just off the top of my head, I'd propose lessening governmental regulation of healthcare. Then the free market would take care of the dearth of doctors. More competition usually lowers costs.

  2. Medicare, believe it or not, is a huge impediment to new doctor creation, as it sets the number of internship seats and thus limits new physician creation.