Doctor Shortage SOS: How Many Physicians Do We Really Need?
"The ongoing debate around physician shortages in Canada highlights the complexities of healthcare planning and the innovative solutions needed to ensure adequate patient care."
Across Canada, concerns about doctor shortages are growing louder. From the New Brunswick Medical Society reporting dozens of family physician vacancies to British Columbia's family medicine 'crisis,' the strain on healthcare systems is evident. Even urban centers like Burnaby are feeling the pinch, with significant doctor shortfalls.
But pinpointing the 'right' number of doctors a region needs is surprisingly complex. According to health economist Arthur Sweetman, traditional supply and demand principles don't neatly apply to universal healthcare. With costs largely covered, demand becomes almost limitless, requiring governments to strategically manage the supply of physicians.
The challenge lies in determining the appropriate level of supply. There's no universally accepted formula, and various academic approaches exist. Government decisions are often influenced by political and financial considerations, adding another layer of complexity to the equation.
New Brunswick Physician Vacancies
The New Brunswick Medical Society reports 39 vacancies for family physicians in the province. It says 50 new positions are needed to meet demand. These figures point to a specific gap in family medicine staffing in New Brunswick.
How Workforce Needs Are Estimated
Workforce planners use physician supply and demand projections, including projections produced by the Association of American Medical Colleges (AAMC), to assess current and possible future policies against plausible demand scenarios. A 2023 paper critically assesses methods for estimating needs-based physician supply and proposes criteria for evaluating them. The AAMC projections assume national supply and demand would have been in equilibrium in 2021 absent the COVID-19 pandemic, while using federal Health Professional Shortage Area estimates as a conservative proxy for current shortages in primary care and psychiatry. AAMC’s most likely scenario projects demand growing faster than supply, with a total shortage of 13,500 to 86,000 physicians by 2036.
A Longstanding Workforce Concern
A historical account of Delaware describes a directory of physicians registered with the clerk of the peace in John Thomas Scharf’s *History of Delaware: 1609 to 1888*. The directory, in the chapter “Medicine and Medical Men,” lists 230 names across a page and part of the next. The account notes that Scharf does not include other healthcare providers, such as barbers, nurses, or unregistered doctors. More recent national projections also indicate concern about future supply: HRSA projects shortages of 57,259 physicians in 2025, 79,080 in 2030, and 81,180 in 2035, while AAMC forecasts 13,500 to 86,000 by 2036.
Unpacking the Methods: How Do We Calculate Doctor Needs?
One common method is the 'needs-based assessment.' Experts evaluate the burden of disease within a population and then estimate the number of doctors required to provide optimal care, based on best practice guidelines. However, these guidelines are constantly evolving, and the resulting figures often exceed what any jurisdiction can realistically achieve. Even France, known for its physician abundance, falls short of these ideal numbers, according to Sweetman.
- Needs-Based Assessment: Experts estimate disease burden and determine required doctors based on best practices.
- Service-Target Approach: Regions compare doctor-to-population ratios and service hours against benchmarks.
- Marginal Approach: Health ministries assess past situations and adjust doctor numbers based on demographic shifts.
A Sharp Urban–Rural Adequacy Gap
HRSA’s December 2025 physician workforce projections for 2023–2038 indicate that nonmetropolitan areas are projected to have greater shortages across physician types than metropolitan areas. By 2038, projected supply adequacy across all physician specialties is 42% in nonmetro areas, equivalent to a 58% shortage. In metro areas, projected adequacy is 95%, or a 5% shortage. A separate article says increasing the pipeline of U.S.- and internationally trained physicians and expanding the supply and scope of practice of nurse practitioners and physician assistants could help mitigate shortages.
Enrollment Growth Has Not Ended the Shortage
A January 2026 data analysis reports that the U.S. physician shortage is worsening despite increases in medical school enrollment and residency growth. It describes the shortage as driven by multiple forces that reduce effective physician supply. The article’s framing suggests that expanding training numbers alone has not resolved the problem. An AMA statement also calls the physician shortage an urgent national issue and argues that it is not a problem to set aside for the future.
Shortfalls Across Physician Categories
AAMC projects that by 2036 the United States will face a shortage of 20,200 to 40,400 primary care physicians. Its estimate for surgical specialties is 10,100 to 19,900 physicians. The same category-specific figures appear in both AAMC summary reports. A separate statistics page gives the surgical estimate as 10,000 to 19,900, so the sources differ slightly on the lower end; the AAMC reports specify 10,100.
Beyond Numbers: Innovative Solutions for a Changing Landscape
Simply increasing medical student enrollment won't solve the immediate problem due to the lengthy training process and limited residency positions. Instead, provinces like New Brunswick and British Columbia are exploring innovative solutions, such as recruiting doctors from other regions and countries. They're also focusing on optimizing the effectiveness of existing physicians.
Workload and Access to Care
Sermo describes the physician shortage as affecting doctors’ workloads and patient care. The supplied source material also identifies the U.S. primary care physician shortage as a growing barrier to accessing healthcare, and notes shortages in specialties including cardiology and dermatology. Together, these reports connect workforce shortages with clinicians’ working conditions and patients’ ability to obtain care. The material does not provide a specific measure of those effects.
Recognizing that modern doctors prefer team-based approaches and diverse payment models, British Columbia is implementing primary care networks. These networks group doctors and other healthcare professionals to allow for more patient time and less administrative burden. New Brunswick is facilitating patient sharing through electronic medical records, phone consultations, and online scheduling. These changes have already reduced wait times significantly, according to Anthony Knight.
As healthcare evolves with integrated teams of professionals, the question of 'how many doctors' becomes increasingly complex, says Sweetman. The focus shifts to determining the right mix of healthcare practitioners and teams needed to deliver comprehensive care. Adaptability and a willingness to embrace changing scopes of practice are crucial for ensuring accessible and effective healthcare for all.