The Association of American Medical Colleges' Local Area Physician Workforce Modeling Project

Area of Science:

• Health Services Research
• Health Workforce Modeling
• Dynamic Systems Simulation

Background:

• Effective physician workforce planning requires addressing physician numbers, geographic distribution, and adaptation to new care models.
• Existing national workforce planning tools are insufficient for local-level planning needs.
• Local health systems and medical educators lack adequate tools for projecting policy impacts on physician supply and demand.

Purpose of the Study:

• To describe a dynamic simulation model developed as a pilot project for physician workforce planning in two metropolitan areas.
• To serve as a prototype for tools enabling medical educators and local health systems to project policy effects on physician supply and demand.
• To incorporate stakeholder input for developing a robust causal structure reflecting local healthcare dynamics.

Main Methods:

• Utilized system dynamics and group model-building approaches with local stakeholder participation.
• Modeled determinants of primary and specialty care demand, including demographic changes and chronic illness.
• Projected physician supply based on residency completions, migration, and retirement, incorporating feedback loops between supply and demand.

Main Results:

• Simulated scenarios included increased demand (e.g., insurance expansion) and increased supply (e.g., practice incentives).
• Evaluated the impact of expanding advanced practice registered nurse and physician assistant capacity.
• In Albuquerque, a combined scenario of increased demand and supply strategies yielded the largest increase in local physician supply.

Conclusions:

• Dynamic simulation models, developed with stakeholder input, can effectively support local physician workforce planning.
• The prototype model demonstrates the feasibility of projecting policy impacts on physician supply and demand.
• Findings highlight the potential of integrated strategies to address local physician workforce challenges and improve healthcare access.