Appointments Scheduled Months Ahead, Overburdened Specialists, Emergency Rooms Struggling: The Physician Shortage is Already Upon Us

The shortage of physicians is a critical challenge, with demand surpassing supply and healthcare facilities experiencing significant pressure. Appointments are being arranged months ahead, specialists are overtaxed, and emergency departments are finding it difficult to maintain sufficient staffing levels. The Association of American Medical Colleges forecasts a deficit of over 124,000 physicians by 2034. However, these projections fail to account for the daily exit of doctors from the profession, whether due to early retirement, transitioning to nonclinical positions, or pursuing more rewarding work environments.

Rather than questioning the motivations behind their exit, which are well-established, the emphasis should be on how we can retain them in practice or entice them back on their terms.

Obstacles, Not Burnout

While burnout is frequently emphasized, the underlying issues driving the exodus of physicians are systemic obstacles: restrictive contracts, rigid and volume-oriented payment structures, burdensome administrative tasks, and limited physician autonomy. These elements together contribute to an untenable work environment.

Nonetheless, this crisis offers a chance to reform and enhance the medical field by addressing these systemic challenges.

Eliminate Non-Compete Clauses Now

Non-compete agreements do not improve patient care but instead undermine continuity, restrict access, and penalize physicians seeking better employment opportunities. The Federal Trade Commission is contemplating a nationwide ban on these agreements, but states should not delay awaiting federal measures. Initiatives such as those in South Carolina aim to exempt physicians, ensuring they remain in their communities even when changing employers, thereby enhancing access to care in underserved areas.

Allow Doctors to Move Away from Third-Party Payers

Physicians are reevaluating care delivery, frequently choosing to disengage from third-party payers. Direct primary and specialty care memberships as well as hybrid models are surfacing to provide more accessible services, clear pricing, and stronger doctor-patient relationships. Some practices are directly contracting with employers or adopting telehealth-first models. These approaches decrease administrative pressure and restore decision-making independence. Policies should back these innovations with tax incentives and grants, allowing physicians to establish sustainable, patient-centered practices.

Independent Practice is Rebounding

Independent medicine is seeing a revival, with physicians embracing hybrid, direct primary care, and cash-pay frameworks to lower bureaucracy and regain control. Indiana’s recent tax credit for independent practices serves as a model that could spark national incentives, rejuvenating community-based, independent practices.

Legislation is Gradually Advancing, Just Barely

State legislatures are starting to dismantle outdated regulations that obstruct physician-led care. For example, repealing Certificate of Need (CON) laws eliminates barriers to establishing doctor-owned facilities. Granting tax credits to physicians providing charity care, particularly in rural settings, supports financially viable, mission-oriented practices.

Develop More Physicians, More Intelligently

Confronting the physician shortage requires training additional doctors. However, federally funded residency positions have hardly increased despite rising demand. Expansion efforts should focus on primary care, rural healthcare, and high-need specialties. Additionally, simplifying the integration process for qualified foreign-trained physicians can help fill crucial gaps.

A Turning Point

The aim is not just to preserve the profession, but to transform it. Neither doctors nor patients are requesting a return to the past. They are advocating for a future where autonomy, sustainability, and patient care coexist. Legislative reforms, grassroots innovation, and changing patient demands indicate the path forward. Policymakers must catch up.

Addressing burnout alone will not solve the healthcare crisis. It is essential to eliminate systemic barriers that repel physicians and complicate their return. Our priority should be to foster a supportive atmosphere that promotes the reinstatement and retention of medical professionals.

Marcelo Hochman is a facial plastic and reconstructive surgeon.