Background: Despite efforts to mitigate a projected primary care physician (PCP) shortage required to meet an aging, growing, and increasingly insured population, shortages remain, compounded by the COVID-19 pandemic, growing inequity, and persistent underinvestment.
Objective: We examined primary care workforce trends over the past decade and revisited projected primary care clinician workforce needs through the year 2040.
Design And Participants: Using data from the AMA Masterfile and Medical Expenditure Panel Survey (MEPS), we analyzed trends in the number of primary care physicians (PCPs) and in outpatient PCP visits by age and gender over the past decade. We then used the Medicare PECOS and Physician & Other Practitioners datasets to identify nurse practitioners (NPs) and physician assistants (PAs) in primary care.
Measures: Using these baseline clinician enumerations and projected population growth estimates from the US Census Bureau for the years 2020-2040, we calculated estimated primary care workforce needs by 2040.
Key Results: The effects of aging and population growth and baseline shortages in the primary care workforce call for significant increases in the primary care workforce to accommodate rising demands. Office visits to primary care clinicians are projected to increase from 773,606 in 2020 to 893,098 in 2040. We project a need for an additional 57,559 primary care clinicians by 2040.
Conclusions: Workforce shortages in primary care continue to expand due to population aging, growth, and heightened rates of clinician burnout & egress.
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http://dx.doi.org/10.1007/s11606-024-09121-x | DOI Listing |
Int J Surg
January 2025
Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Microsurgery demands an intensive period of skill acquisition due to its inherent complexity. The development and implementation of innovative training methods are essential for enhancing microsurgical outcomes. This study aimed to evaluate the impact of a simulation training program on the clinical results of fingertip replantation surgeries.
View Article and Find Full Text PDFInt J Surg
January 2025
Department of Cardiovascular Surgery, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Beijing Anzhen Hospital Capital Medical University, Nanchong, China.
Objective: This systematic review and meta-analysis aimed to evaluate and compare the efficacy of endovascular versus open repair for the treatment of patients with descending thoracic aortic aneurysm (DTAA).
Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases for relevant studies was performed. Outcome data, including postoperative mortality and morbidity, operative details, all-cause survival, freedom from aortic-related survival and freedom from aortic-related re-intervention, were independently extracted by two authors in a standardized way.
JAMA Intern Med
January 2025
Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
Importance: SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) contribute to many hospitalizations and deaths each year. Understanding relative disease severity can help to inform vaccination guidance.
Objective: To compare disease severity of COVID-19, influenza, and RSV among US veterans.
JAMA Pediatr
January 2025
Vascular Assessment and Management Service, Department of Anaesthesia and Pain, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Queensland, Australia.
Importance: Pediatric peripheral intravenous catheter (PIVC) insertion can be difficult and time-consuming, frequently requiring multiple insertion attempts and often resulting in increased anxiety, distress, and treatment avoidance among children and their families. Ultrasound-guided PIVC insertion is a superior alternative to standard technique (palpation and visualization) in high-risk patients.
Objective: To compare first-time insertion success of PIVCs inserted with ultrasound guidance compared with standard technique (palpation and visualization) across all risk categories in the general pediatric hospital population.
JAMA Intern Med
January 2025
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Importance: There are no validated decision rules for terminating resuscitation during in-hospital cardiac arrest. Decision rules may guide termination and prevent inappropriate early termination of resuscitation.
Objective: To develop and validate termination of resuscitation rules for in-hospital cardiac arrest.
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