Why the physician shortage is a 'public health crisis'

During the pandemic, many healthcare workers retired or quit, and since then, it has been difficult to find physicians and other providers to replace them.

According to a report from the National Association of Community Health Centers, 67% of federally qualified health centers (FQHCs) lost between 5% and 25% of their workforce during a six-month period in 2022. Another 15% of FQHCs lost between 25% and 50% of their workforce, with the most severe shortages among nurses.

The shortage of clinicians has also increased the workload of support staff, including medical assistants and other unlicensed workers. Some of the extra tasks support staff are handling include "sterilizing equipment, keeping more logs, keeping more paperwork, working with larger patient loads,'' said Jesse Martin, EVP of the Service Employees International Union 1199 New England.

"When you add that work to the same eight hours worth of a day's work you can't get everything done," Martin added.

Community health centers are also caring for more patients than before, further straining their limited workforce. Between 2015 and 2022, the number of people served by community health centers nationwide increased by 24%.

"As private practices close or get smaller, we are seeing patient demand go up at the health centers,'' said Elena Nicolella, president and CEO of the Rhode Island Health Center Association. "Now with the workforce challenges, it's very difficult to meet that patient demand."

Overall, Jesse Ehrenfeld, president of the American Medical Association, said the current physician shortage is a "public health crisis."

"It's an urgent crisis, hitting every corner of this country – urban and rural,'' Ehrenfeld said, "with the most direct impact hitting families with high needs and limited means.''

As more doctors leave, patients are losing trust

With fewer providers available, patients often have a harder time finding care, with many turning to urgent care for their health concerns.

"We're seeing a lot of people coming in for things that are really primary care issues, not urgent care issues, just because it's really hard to get appointments," said Carla Martin, a physician who often gets called to fill in at urgent care clinics.

A lack of providers has also affected patients' ability to form a care relationship and has negatively impacted their trust in the healthcare system.

For example, Piedad Fred, a 71-year-old Colombian immigrant, no longer had a regular doctor after one retired and another left the health center she typically visited. She has also had more difficult time accessing care, from making appointments to getting her prescriptions filled.

"I don't know,'' Fred said. "To go to a doctor that doesn't know who you are? That doesn't know what allergies you have, the medicines that make you feel bad? It's difficult...I know that I feel cheated, sad, and like I have my hands tied.''

Instead of going to the community health center or a doctor's office the next time she needs care, Fred said she plans to go to the hospital. However, experts say that more people going to hospital EDs for care will likely only further strain healthcare workers and the healthcare system as a whole. (Arditi, "Shots," NPR, 12/22)

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