Physicians worked fewer hours during the pandemic's 2020 peak

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The COVID-19 pandemic has had a profound effect on almost every aspect of healthcare delivery, and this extends all the way down to individual physicians, with physicians working fewer hours on average in 2020 compared to 2019 according to data published in JAMA Network Open. 

Before the start of the public health emergency, 84.17% of physicians reported working full time. But that percentage dipped to 80.65% during 2020, and those who claimed to "still have the same activities" at work saw an even steeper decline, from 83.9% to 78%, almost a six-point drop.

It was rare to see physicians laid off during the pandemic, but there was an increase among those who said they'd lost their jobs, from 0.05% before the pandemic to 0.45% during the pandemic.

WHAT'S THE IMPACT

What this means is that physicians' work hours have significantly decreased since the start of the COVID-19 pandemic in the U.S., accelerating an existing, gradual decline. These changes may reflect a decrease in healthcare utilization and the increased flexibilities brought by COVID-19–driven regulations, the authors said.

The data comes from the Current Population Survey (CPS) basic monthly data from January 2019 to December 2020, obtained through the Integrated Public Use Microdata Series (IPUMS). Administered by the U.S. Census Bureau, the CPS contains demographic and employment information. Participants were interviewed eight times during a 16-month period.

The resultant findings also showed that the percentage of parents of preschool-aged children among full-time female physicians dipped from 17.98% to 14.1%. The number didn't change significantly among male physicians. Authors said this suggests a potentially disproportionate uptake of childcare responsibilities among female physicians during the public health crisis.

They caution that the sample size of physicians was small and lacked detailed information, necessitating further research to examine the effects of COVID-19 on the physician workforce.

THE LARGER TREND

A faltering employment situation threatens to undermine the healthcare industry's recovery from the pandemic, and exacerbates an already-pressing physician shortage, which is poised to worsen over the next decade-plus, according to data published by the Association of American Medical Colleges. 

The U.S. could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in both primary and specialty care, AAMC found. 

Primary care, including family medicine, general pediatrics and geriatric medicine, is on pace for a shortage of between 17,800 and 48,000 physicians. But the numbers for non-primary care specialties are even direr: A shortage of between 21,000and 77,100 physicians is expected over the next several years.

Even before the COVID-19 pandemic, physician shortages were being felt by patients across the country. In 2019, the U.S. Health Resources and 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. That's a 10-point increase from when the question was asked in 2015.

At the end of 2020, Congress attempted to address the physician shortage by adding 1,000 new Medicare-supported graduate medical education (GME) positions – 200 per year for five years – targeted at underserved rural and urban communities and other teaching hospitals nationwide, ending a nearly 25-year freeze on Medicare support for GME. 

Bipartisan legislation recently introduced in both the U.S. House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2021, would build on that investment and help expand the physician workforce by adding 2,000 federally-supported medical residency positions annually for seven years.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com