The Physician Shortage-Projections, Causes, and Solutions W…

The Physician Shortage: Projections, Causes, and Solutions

Reduced barriers to entry for International Medical Graduates. The U.S. physician workforce is supplemented by physicians who completed their medical education abroad. About one-quarter of physicians in active patient care in the U.S. today are International Medical Graduates (IMGs). Without the presence of IMGs, who often practice in rural areas for visa related reasons, the physician shortage would be considerably more acute.

IMGs must complete a U.S. residency training program to obtain a license to practice in the U.S., a requirement that greatly limits their availability.

Some states are taking steps to eliminate this requirement. Tennessee passed a law that became effective in July 2024 (though it has not yet been implemented) that will make it the first state to allow IMGs to practice in the U.S. without having to complete a U.S.-based residency.

An Illinois law to take effect on January 1, 2025 would allow IMGs without a U.S. residency to practice in the state provided they work in an underserved area. Florida, Virginia, Idaho and Wisconsin are considering similar legislation.

Eliminating the U.S. residency requirement for IMGs is a dramatic step that clearly underscores the urgent need for physicians, particularly in rural areas, and which has the potential to significantly increase physician supply.

Appropriate use of providers. Efficiency gains can be realized through the appropriate use of the various providers on the patient care team. The goal is for each provider to practice to the top of his or her training. In this workforce management model, physicians focus on the most complex problems they are trained to address, while leaving less complex duties such as surgical prep or patient education and follow-up to NPs or PAs. Nurses also focus on patient care and leave other duties, such as stocking supplies or moving patients, to others on the team. In this way, the number of FTEs devoted to actual patient care is expanded.

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