The need for health care will continue to grow as the population in the US ages. This one issue will make the demand for physicians to increase and if left uncorrected will lead to shortages. There are several other factors are impacting this problem, the shrinking economy, the aging population and finally the impending health care "reform".

Primary Care Shortage

American Academy of Family Physicians suggests there will be a shortage of 40,000 primary care doctors (Family Practice jobs, Internal Medicine jobs, Pediatric jobs and OB/GYN) by 2020. Added to this shortage is the fact that the number of medical students choosing primary care as a profession has already dropped by 51.8% since 1997, and that currently only 2% of medical school graduates choose primary care as a career. The drop in interest in primary care is likely a response to the significantly higher salaries that sub specialists like Radiologists, Cardiologists and many others command.

Bad Economy and Aging Population

With the recession and massive job loss across the country has had a direct impact on the revenue stream to physicians. When people lose their job, they also lose their health care benefits and so access to health care. Obviously, this is felt more in some parts of the country than others but since most hospitals are part of regional or national chains they are all affected by this. This should mitigate some shortages short term.

The recent stock market collapse has had a major impact on older physicians' decisions. Many doctors are postponing retirement because of the economy's impact on their retirement savings. But even a three- to five-year delay won't address the impending loss of experienced physicians. This postponement has resulted in fewer jobs being offered and graduating residents not finding as many opportunities as before. Residents rather than committing themselves to less desirable jobs are opting for locum tenens jobs and waiting before committing to full time employment. So for the short term, it appears there are fewer good jobs available.

Health Insurance Reform

Another uncertainty is the outcome of national health reform. If the health care reform actually works in increasing the enrollment into health care insurance then the long term the aging population and these increased numbers should push demand for services and therefore cost higher. However, no one yet knows what will happen to reimbursement rates from Medicare. Already there has been some lowering of rates they pay in Radiology which has directly impacted that specialty. The question is will there be more rates cut that will affect all specialties.

Because of these and other factors many physician practices are holding off making any decisions until they have a better idea of how the health reform will impact these reimbursements.