The pandemic worsened the US physician shortage crisis, factors like physician burnout are speeding up retirement.

According to new data published today by the AAMC (Association of American Medical Colleges), the United States could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in both primary and specialty care.

“The COVID-19 pandemic has highlighted many of the deepest disparities in health and access to health care services and exposed vulnerabilities in the health care system,” said AAMC President and CEO David J. Skorton, MD. “The pandemic also has underscored the vital role that physicians and other health care providers play in our nation’s health care infrastructure and the need to ensure we have enough physicians to meet America’s needs.”

The seventh annual study, The Complexities of Physician Supply and Demand: Projections from 2019-2034, was conducted for the AAMC by the Life Science division of IHS Markit, a global information company. This analysis, conducted in 2019 prior to the start of the COVID-19 pandemic, includes supply and demand scenarios and was updated with the latest information on trends in health care delivery and the state of the health care workforce, such as data on physician work hours and retirement trends.

“Physicians and other health professionals dedicate their careers to keeping people healthy and caring for us when we are sick. During the past year, these individuals and their families have made enormous personal sacrifices as they responded to the COVID-19 pandemic and we owe them an immense amount of gratitude,” Skorton said.

In his testimony during a recent congressional hearing on addressing the dire health care workforce shortage, Skorton noted that the issue of increasing clinician burnout, which has been intensified by the pandemic, could cause doctors and other health workers to cut back their hours or accelerate their plans for retirement.

Other key findings from the report include:

Demographics — specifically, population growth and aging — continue to be the primary driver of increasing demand from 2019 to 2034. During this time, the U.S. population is projected to grow by 10.6%, from about 328 million to 363 million, with a projected 42.4% increase in those aged 65 and above. Therefore, demand for physician specialties that predominantly care for older Americans will continue to increase.

A large portion of the physician workforce is nearing traditional retirement age, and supply projections are sensitive to workforce decisions of older physicians. More than two of every five active physicians in the U.S. will be 65 or older within the next decade. Their retirement decisions will dramatically affect the magnitude of national workforce shortages. Additionally, according to the AAMC’s 2019 National Sample Survey of Physicians, 40% of the country’s practicing physicians felt burned out at least once a week before the COVID-19 crisis began—and the issue of increased clinician burnout could cause doctors and other health professionals to reduce their hours or retire sooner.

If marginalized minority populations, people living in rural communities, and people without health insurance had the same health care use patterns as populations with fewer barriers to access, up to an additional 180,400 physicians would be needed now. COVID-19 has put a spotlight on disparities in health and access to care among underserved populations, and this analysis underscores the systematic differences in health care services by insured and uninsured individuals, individuals in urban and rural locations, and individuals of differing races and ethnicities. These estimates, which are separate from the shortage projection ranges, help illuminate the magnitude of current barriers to care and provide an additional reference point when gauging the adequacy of physician workforce supply.

Even before the COVID-19 pandemic, physician shortages were being felt by patients across the country. In 2019, the U.S. Health Resources & Services Administration estimated that an additional 13,758 primary care physicians and 6,100 psychiatrists would have been needed to remove Health Professional Shortage Area designations for areas with primary care and mental health shortages. According to public opinion research conducted by the AAMC in 2019, 35% of survey respondents said they or someone they knew had trouble finding a doctor in the past year or two. This is a 10-point increase from when the question was asked in 2015.