New tool helps predict distribution of clinical services

FutureDocs shows where shortages of doctors might affect access to care, says Bill Adamson, MD.

An application is helping physicians assess future needs for their healthcare services and where they will be needed.

That tool, sponsored by the Physicians Foundation and developed by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill, looks to help clinicians better understand where shortages of medical services might exist in the future.

Problems with the distribution of access to medical services are widely anticipated in the future. This year, the nation’s physicians are able to meet 96 percent of requests for patient visits, but by 2030 the gap between physician capacity and patient demand for services could become significant, with a shortage of at least 40,800 physicians to as many as 104,900, even as the Medicare population ages, according to the Association of American Medical Colleges.

However, a report from the Institute of Medicine in 2014 painted a much rosier picture of the physician workforce and graduate medical education, finding no shortage of clinicians but a looming misdistribution of physicians geographically and by specialty.

Nonetheless, the FutureDocs Forecasting Tool aims to tell clinicians and others where shortages are likely to exist in the future. The tool is a model to inform policymakers of future projections of visit demands, estimating the supply of physicians and capacity of that supply to meet future use of services at local, state and national levels between now and 2030.

“You can manipulate input and questions, and that changes the output,” explains Bill Adamson, MD, a pediatric surgeon and division chief for pediatric surgery at UNC, an early adopter of the application.

The power of the tool, he adds, is to provide a way to look at the future demand for doctors in a way that is useful and relevant, enabling analysis using variables such as physician availability, patient numbers, patient demographics and medical problems.

For example, a query about physician availability in a specific neighborhood of New York City may find that another 20 physicians of a particular specialty are needed in the neighborhood. Consequently, policymakers can be informed of the specialist shortage and financially incentivize physicians to move into the neighborhood, or reduce reimbursement in overserved areas to encourage doctors to move to an underserved region.

Findings made using the FutureDocs Forecasting Tool also can fuel discussions in medical schools on whether new programs should be created to develop more physicians for specific disciplines.

For example, Adamson believes that, within 20 years, the nation will have too many pediatricians. If too many students are trained in pediatrics, they may not have enough business to develop optimal skills. “You don’t want a surgeon who hasn’t done surgery in two years,” he adds. “We need to right-size ourselves for the future.”

Use of FutureDocs is easy—any doctor can use it to enter variables such as specialty or region and see the concentration of doctors in the region. Medical students can do the same and see where competition is fierce and where it is not.

Larger health systems likewise can use the tool to decide where to put resources—they may add resources at a particular hospital and send more patients there. “You can spend just a couple minutes on FutureDocs and understand it,” Adamson says.

The tool also supports insurers, helping them become shrewder in how they pay physicians, by telling the clinicians.

More information on the FutureDocs Forecasting Tool is available here.

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