Northwell study: Demand for physicians growing 'faster than supply'

The demand for medical doctors on Long Island and across the country to treat a rapidly aging population "will grow faster than supply" over the next decade, with a potential shortage of close to 124,000 primary care and specialty physicians by 2034, according to a Northwell Health study.

Physicians focused on treating older Americans — among those patients, medical doctors reaching retirement age by the mid 2030s — will be in high demand, even as a shortage of specialists of between 21,000 and 77,100 nationwide is projected, according to the study by Northwell's Institute of Health System Science at the Feinstein Institutes. 

The study projects a shortage of between 17,800 and 48,000 primary care physicians by 2034.

Researchers analyzed the career paths of 61,991 primary care track internal medicine residents from 2019 through 2021 and found that just 10% of graduating medical students had chosen to practice general medicine.

A quarter-century ago, 40% of graduates practiced general medicine, said Dr. Lauren Block, who co-authored the study. Block and her team also found that the percentage of residents becoming "hospitalists," who primarily work in hospitals, has increased, while the number going into outpatient or primary care has fallen. Since residents train in hospital settings, it is “natural” for them to continue working in an environment they already know, Block said, and one that provides a certain amount of resources and mentors.

General medicine is an umbrella term for physicians who provide primary health care, such as family doctors, pediatricians, and internists, who are specially trained in diagnostic medicine, preventive medicine, and the management of long-term illnesses.

“We've been noting locally, difficulty recruiting physicians and really providers of every profession to join us in primary care,” Block said.

Hospitalists can earn more than outpatient or primary care physicians. Since reliable estimates have the average medical school graduate shouldered with about $202,453 in debt, future doctors must make tough decisions.

“Debt does impact career choices," said Dr. Gladys M. Ayala, dean of the NYU Grossman Long Island School of Medicine in Mineola. In July, the medical school received a $200 million donation from Long Island native Ken Langone and his wife, Elaine, to fund full-tuition scholarships for all students. 

This year, annual tuition would be $59,738 without the grants. The school has provided full-tuition grants to all students since it opened in 2019, but previously it did not have an endowment to make them a permanent feature.

The tuition-free, three-year program is a key component in minimizing student stress, Ayala said, adding that the curriculum was specifically created to guide medical students along a pathway to becoming general primary care physicians.

“If we can eliminate and minimize the debt, we hope that frees the student to choose these fields that we know they are passionate to go into,” Ayala said.

Dr. Michael Leitman, dean for graduate medical education at the Icahn School of Medicine at Mount Sinai, said there are more physicians retiring than being trained to practice in metropolitan areas, including Long Island.

“We have a growing population, and we have fewer providers per person taking care of older, sicker patients,” said Leitman. “And that problem is getting worse and worse.”

To combat this, Mount Sinai offers residency programs in family medicine, combined with internal medicine and pediatrics, at its South Nassau hospital, and emphasizes primary care.

It also offers a need-based financial program that ensures all of its students graduate with no more than $75,000 in debt, according to Leitman.

“You often find out that people who go on and do fellowships in gastroenterology or cardiology, they earn up to five times more than people who go into practice in primary care,” he said.

Dr. Todd Griffin, vice dean at Stony Brook Medicine, said that its new Advanced Specialty Care facility at Smith Haven Mall in Lake Grove is part of the system’s strategy to grow its primary care services.

The “medical mall” is a consolidation of previous offices, and offers primary and specialty care offices in a 60,000-square-foot space.

“It also did allow for the primary care groups that we moved in there to have opportunities for growth,” Griffin said. “Their spaces are a little bigger, so that we can add more doctors.”