Online Tool Helps Predict Physician Demand And Supply

By Christine Kern, contributing writer

Forecasting tool will bring new data and insight to the physician shortage debate.

Launched by The Physicians Foundation and the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, the FutureDocs Forecasting Tool is an interactive web-based model that estimates the supply of physicians, use of physician services, and capacity of the physician workforce to meet future use of health services at the sub-state, state, and national levels.

"The tool is a significant advance in workforce modeling because it is based on the concept of plasticity--the idea that physicians in different specialties have overlapping scopes of practice," say UNC officials. "Plasticity takes into account the multiple configurations of physicians able to meet patients’ needs for care in different communities. The majority of current national workforce models focus on silo-based projections by physician specialty."

The FutureDocs Forecasting Tool will allow healthcare providers and anyone interested to be more aware to fluctuations in what specialties of doctors will or will not be available in the near future. With the possibility of adding Medicaid to the Affordable Care Act, there comes the risk of an overwhelming number of patients to a limited number of doctors, which may potentially pose a problem. However, the FutureDocs tool can accurately evaluate the number of available physicians and their specialties of any particular local to even national area. The tool also accounts for differing variables that may occur, including situations like expansion of Medicaid.

The Web-based application incorporates the concept that specialists have overlapping "scopes of practice" to provide a customizable display of physician shortages or surpluses in various locations. It can track and predict changes from 2011 to 2030. The interactive tool can be adjusted for different scenarios, including:

• Adoption of state insurance exchanges or Medicaid expansion;
• Alterations to the amount of patient care full-time employees;
• Redistribution of graduate medical education slots; and
• The use of nurse practitioners and physician assistants.

In addition, researchers used feedback from physicians and hospital groups to frame the tool's supply and delivery data in the most realistic way possible.

Using FutureDocs, researchers found the physician shortage problem is caused in part by the way doctors are distributed among specialties, rather than a lack of doctors. Specifically, the researchers found:

• Capacity to treat pediatric surgery patients could double by 2030;
• The number of patient care full-time employees could decline by 12 percent in general internal medicine between 2011 and 2030; and
• The number of mental health visits already exceeded capacity in 2011 and could become worse by 2030.

The researchers suggested that the tool can be used to address physician distribution problems and suggest more efficient spending on graduate medical education.

Dr. Erin Fraher, Assistant Professor in Family Medicine at the UNC School of Medicine and leader of the team that developed the tool, explained the model and forecasting reveal the national issue is not the lack of doctors, but what kind of doctors there are. “The key message from our findings is that everyone is talking about national shortages of upwards of 130,000 physicians, and in fact, our model shows that overall the workforce nationally and in North Carolina is in balance,” says Dr. Fraher. “The main issue is one of distribution. We don’t have physicians in the right places, and we don’t have them in the right specialties.”

 “We hope that health systems and others will use the data to help figure out innovative ways that they might configure their workforce,” says Dr. Fraher. “We want to give people the data they need to redesign the way they are delivering care and have the information they need to know what’s coming down the pike for them.”