According to a new Need Report for Medical Specialists 2023-2035, it indicates that although there is a shortage in family and community medicine, an increase in this specialty is expected in 2029.
He Ministry of Health just published a new Need Report specialist doctors 2023-2035 which reflects that, today, the health system has a global deficit of 5,874 specialists although within eight years, according to the study, “a slight surplus” is expected to increase to a 2.5% in 2035.
In the case of Family and Community Medicinecurrent deficit is 4,502 doctors, a figure that, according to the report, will increase to 5,496 professionals in 2029, although the following year, “the change of sign from deficit to balance will begin (around the lack of some 2,100 family doctors in 2035, less than a 5% deficit).
The report, which has been redrafted by Patricia Barber and Beatriz González López-Valcárcelfrom the University of Las Palmas, points out that this update of the previous one, carried out in the middle of the fifth wave of covid and published in January 2022, “collects new figures of public employment of doctors on the SNS until February 28, 2023once the pandemic situation is over and after the stabilization of the reinforced health workforce to face it.”
For the first time, the Spanish Private Health Alliance (ASPE)a private healthcare association in Spain that brings together almost 1,300 entities with a representation of more than 80% of the country’s private hospital centers, collaborates with the study by providing first-hand information on medical employment in the private sector.
“This is a new and valuable source of information, which contributes to improving the estimate of the number and distribution of doctors working in the private network. While complete data is not available in the State Registry of Health Professionalsthe data on the employment of medical specialists in the private network will be based on estimates, and therefore are subject to errors and uncertainty,” the authors point out.
The report highlights the work prevalence part-time in private practice, making it compatible with work in the public network. Specifically, there are 14 specialties with more than 75% of their part-time doctors in the private network.
In total, it is estimated that the number of active doctors in Spain in 2023, including private healthcare, amounts to 190,861, which represents a ratio of 400.05 specialist doctors per 100,000 inhabitants.
SUPPLY AND DEMAND OF SPECIALISTS
The new projections included in the report suggest that the supply of specialist doctors in all branches “will grow between 2023 and 2035 by 28.8% compared to a 22% growth in the demand for doctors.” With the data in hand for 2023, the report registers a global deficit of 3.0% (5,874 doctors), but the predictive model of the analysis foresees a gradual reduction of this deficit due to the greater relative increase in supply than demand.
Thus, “in 2032 the trend towards a slight surplus of specialist doctors. Although it is the result of multiple concomitant factors, demographic dynamics and the continued increase in MIR training places have a significant impact on this pattern,” the report states. By 2035, the report estimates that there will be a demand for 242,802 specialists in to a bid of 249,155, which translates into a surplus of professionals of 6,653 personnel (2.5%).
POPULATION PYRAMID
Regarding the evolution of the main demographic indicators of the population pyramid of doctors, the study concludes that “the feminization trend will continuefrom 60.1% women in 2023, to 64.8% in 2035″.
Furthermore, the authors say, “the process of rejuvenation of the professionsince, from a predominantly aged population, especially in some specialties, there is a transition to a young population of doctors, as a result of the high replacement rates of recent years with high retirement rates that are compensated by the numerous new cohorts of specialists via MIR”.
Immunology and Clinical Pharmacology will be extremely reduced until 2035
The data show that the overall rate of specialist doctors between 50 and 65 years old “falls by 14.5% until 2035 and the cohort between 60 and 65 years old will reduce by around 7%, according to estimates, from 16.6%, which currently represents 9.3% estimated for 2035. Only the group of people over 65 years of age are expected to grow in the prediction horizon, from 0.4% today to 2% in 2035″.
POPULATION RATIOS BY SPECIALTY
Regarding the population rates of available doctors by specialties, the report indicates that there are seven specialties that will reduce your ratios population between 2023 and 2035 more than 20%: Plastic Surgery (-20%), Pediatric Surgery (-28%), Thoracic Surgery (-60%), Cardiovascular Surgery (-57%), Clinical analysis/Clinical biochemistry (- 77%), and Immunology and Clinical Pharmacology. “These two specialties, already very minority in 2023, will be extremely reduced“the authors predict.
At the other extreme, that is, specialties that your ratios will increase population in 2035, more than 40% of its personnel are six: Intensive Medicine, Preventive Medicine and Public Health, Family and Community Medicine, Internal Medicine, Neurology and Medical Oncology.
Nine other specialties They will increase their offer between 30% and 40%: Psychiatry, Cardiology, Anesthesiology and Resuscitation, Physical Medicine and Rehabilitation, Pediatrics, Hematology and Hemotherapy, Radiodiagnosis, Pulmonology and Digestive System.
Other specialties such as General Surgery, Obstetrics and Gynecology, Ophthalmology, Dermatology, Orthopedic Surgery and Traumatology and Endocrinology, will grow practically between 20% and 30%.
There is 21 specialties (practically half of all of them) for which the report foresees reaching a “situation of moderate surplus (more than 10% of the workforce). Ten of them (Digestive System, Cardiovascular Surgery, Hematology, Intensive Care Medicine, Internal Medicine, Preventive Medicine and Public Health, Nephrology, Pulmonology, Neurology and Gynecology and Obstetrics) will have already entered a moderate surplus within five years, in 2029, and the “The pool of surplus professionals will increase in the following six years, until 2035.”
AND FAMILY AND COMMUNITY MEDICINE?
The report dedicates a special section to Family and Community Medicine and the authors recognize that “the difficulties that primary care and especially Family Medicine are going through They are not exclusive to Spain. Many countries face a shortage of family doctors and the difficulty in attracting young people to this specialty,” they point out.
Analyzing data from the OECD, the report points out that “many countries are making efforts to call for more training places in this specialty, although they are not always filled”, as in the case of Spain, where year after year all the places are not awarded.
“After the pandemic, the majority of OECD countries that responded to a questionnaire in early 2022 reported that they were designing incentives to encourage more students to choose general practice for their postgraduate internship/residency in order to address the shortage of physicians, specifically Family Physicians,” the report says.
The deficit of family doctors in 2035 will be below 5%
In previous analyses, Family medicine has been “the specialty with the worst future deficit forecast, although in the previous report it was already some improvement was expected around the years 2026-2027″.
This improvement, according to the authors, “was attributable to the incorporation of the MIR waves, increased after the increase in vacancies called (especially from the cohort that began the MIR in 2019) and to the gradual rejuvenation of the population pyramid of family doctors, one of the oldest.
The model estimates a shortage of family doctors, from the current level in 2023 of 4,502 professionals, to 5,496 in 2029. “From 2030, according to the model, the change of sign will begin. from deficit to balance (around the lack of about 2,100 family doctors in 2035, less than a 5% deficit)”.
Currently, 51.3% of doctors are between 50 and 65 years old and almost one in four, 23.8%, are between 60 and 65 years old. “Therefore, the replacement rate will be high, especially in the next five years, from which it follows a projection of relevant rejuvenation in the age pyramid. In 2029, 33.5% are estimated to be over 50 years old and in 2035, 23.4%. Therefore, the percentages of family doctors over 50 years of age will be reduced to less than half in a decade. The feminization rate will increase by around five points, from 65.7% today to 70.4% in 2035.
HOW MANY MIR PLACES ARE RECOMMENDED
The authors have carried out “a purely numerical exercise” to approximate the number of MIR training places that “would be able to minimize the difference between the supply and demand of family doctors until 2035.”
Thus, they point out that “the minimum net number of places in 2024 that would eliminate the deficit in 2028 is 2,741 places. This supposes a increase on the 2023 supply of 10%. This offer must be maintained in the next three calls and, from then on, be gradually reduced to around 2,500 annual training places in order to avoid an excess of supply above the structural levels in the following years.”