‘People who’ve gone to medical school are not practicing medicine’

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Getting more physicians to work with more patients could be a way to soften the nation’s projected shortage of doctors in the next decade.

Physicians, policymakers and patients all have been pondering how physician workforce trends will affect the nation’s health care system – and medical outcomes for people seeking healing, treatments and cures. Projections by the Association of American Medical Colleges (AAMC) have made headlines trumpeting the need for more of doctors.

But another trend has emerged in doctor employment, said Rep. Greg Murphy, MD (R-North Carolina), co-chair of the House GOP Doctors Caucus. He spoke with Medical Economics this fall.

“I think we have to have a real serious conversation about physician workforce,” he said. “What’s happened? Number one reason we have a physician shortage is, the people who’ve gone to medical school are not practicing medicine.”

‘Not willing to work the hours’

Rep. Greg Murphy, MD (R-North Carolina)

Speaking with Medical Economics, Murphy said the nation’s population is graying, and that includes physicians. His specialty is urology and its practitioners are aging out, leaving a critical shortage, just like in primary care and many other specialties, he said.

The continuing decrease in physician reimbursement by the Medicare Physician Fee Schedule and prior authorizations are other things that torture physicians in private practice, Murphy said. “A lot of people are throwing their hands up,” he said.

But the problem is not just age, money or insurance aggravations. Lifestyle and education also are in play.

“We also have younger physicians coming out and worried much more now about work-life balance and not willing to work the hours that maybe I did when I was young,” he said. “I think the future of medical education – personally, I have some issues with what’s going on in medical education, because I think some of the streams of education have lost their vision about what we should be talking about, and we’re getting on extraneous issues.

“There’s a major issue with what’s going to happen to the physician workforce, and do we cede it to people who, in my opinion, are great members of the team, but perhaps less educated as far as patient care?” Murphy said. “It’s a major issue, and truth be told, I wish our leaders of medical education cared more about that than some of the other social issues that we’re trying to push in medical school.”

Too many or not enough?

Murphy recalled the 1990s, when physicians and other health care watchers publicly proclaimed a huge physician glut. At the time, analysts said America didn’t need more doctors.

In December 1996, JAMA ran the analysis, “Benchmarking the US Physician Workforce: An Alternative to Needs-Based or Demand-Based Planning,” and an accompanying editorial. From 1965 to 1985, the number of allopathic medical school graduates rose 40%, the editorial said. From 1970 to 1993, the nation’s number of doctors grew 65%, the article said.

In March 1997, The New York Times reported: “Doctors Assert There Are Too Many of Them.” The American Medical Association and representatives of the nation’s medical schools claimed “that the United States was training far too many doctors and that the number should be cut by at least 20 percent.”

At the time, it seemed few, if any, industry watchers predicted another trend that emerged and is a factor in 2024.

“They didn’t realize that as populations go in medical schools, we have a lot of folks that go to medical school that are never going to practice medicine,” Murphy said. Some go to work for pharmaceutical companies, he said. Some opt to work part time to raise families or for other reasons.

Murphy cited a meeting earlier this year with dermatologists that had three physicians in practice and plans to bring on two more. “But their model is to only work three days a week, and that’s full-time for them,” he said. “It’s great for them, but it doesn’t fulfill the need for patients.”

More physicians in training

In 1997, the federal Balanced Budget Act capped the number of physician residencies paid for through Medicare. That cap remained in place well into the 21st century.

Last month, the Association of American Medical Colleges (AAMC) announced the U.S. Centers for Medicare and Medicaid Services (CMS) named 109 teaching hospitals across 33 states received 200 additional residency slots starting in July 2025. It was the third distribution of new residencies, and so far, CMS has distributed 600 of 1,200 new residencies created in the federal Consolidated Appropriations Act, 2021 and Consolidated Appropriations Act, 2023.

The same AAMC news release cited the association’s projected physician shortage for 2036, when the nation is forecasted to need another 86,000 doctors.

The new physicians should consider how they will work to help patients, and health care.

“I personally think, if you sign up and go to medical school, you take that seat, you ought to fulfill your goal to practice full time,” Murphy said. “If you don’t want to practice full time, then go be somebody who gets a nurse practitioner degree or a PA (physician associate) or get your PhD if you want to do research.

“We need doctors in the seats, or at the patient’s bedside, in the clinic,” he said. “We don’t need people who are doing other things to go to medical school.”