Retiring, aging physician workforce presents concerns for rural Florida counties

by | Nov 8, 2023

  • Florida faces a looming healthcare crisis as 20 percent of its physicians, aged 60 and above, are nearing retirement without clear replacements, creating shortages particularly in rural counties. 
  • The state has identified 253 primary care Health Professional Shortage Areas and estimates a need for approximately 1,180 full-time equivalent primary care physicians for Medicaid and uninsured populations.
  • Just three counties exceed the federal average of primary care physicians per 100,000 people, highlighting regional disparities in healthcare access.

Rural counties in Florida are on the cusp of an exacerbated healthcare crisis as a growing number of physicians are approaching retirement age, with no clear succession plans in place.

According to data presented to the House Healthcare Regulation Subcommittee on Wednesday, 20 percent of Florida’s physicians, amounting to 65,000 healthcare professionals, are aged 60 or above and are likely to retire within the next five to ten years. Supplementary data aggregated by the Association of American Medical Colleges also showed that Florida ranks sixth among all states in terms of the highest percentage of physicians over 60 years of age.

Per the Physicians Survey conducted by the state, physicians aged 50 to 59 comprise the largest group of Florida practitioners, at 25.2 percent, with an average overall age of 53. Moreover, 4.7 percent, or 2,512 registered physicians in Florida reported that they plan to move out of the state within the next five years.

“While we’ve seen a 33.8 percent increase [in physicians] since 2012 through the current year, the average increase during this period is just three percent,” Florida Department of Health Division of Public Health Statistics Director Emma Spencer told the subcommittee. “For reference, Florida’s overall population has increased by 15 percent during that same time period.”

Using feedback from the survey, the agency identified nine counties where at least 25 percent of their physicians indicated that they intend to retire within the next five years.

“Retirements are disproportionately affecting smaller counties,” said Spencer

Florida ranks 31st in the nation for the number of available primary care physicians per 100,000 people, with 88.5 physicians compared to the national average of 94.4. Looking specifically at the state’s workforce, just three of Florida’s 67 counties — Seminole, Alachua, and Sarasota  — exceed the federal average.

Florida Health has identified 253 primary care Health Professional Shortage Areas (HPSAs) across the state, with most low-population counties classified in their entirety as healthcare shortage regions, while more urbanized counties like Miami-Dade, Orange, and Duval are only partially classified as a HPSA area. To serve the state’s Medicaid and uninsured populations, Florida would need approximately 1,180 Full-Time equivalent primary care physicians, according to Spencer

In an attempt to remedy the current and continuing healthcare shortages, the state is employing a Medical Education Loan Repayment Program, which holds the goal of encouraging qualified medical professionals to practice in underserved locations of the state by providing annual payments to offset loans and educational expenses for nurses, advanced practice nurses, physician’s assistants, and physicians.

By 2035, the state anticipates a shortfall of 17,924 physicians due to population growth and the increasing healthcare needs of an aging population, according to the Florida Safety Net Hospital Alliance and the Florida Hospital Association.

The projected deficit includes 5,974 in “traditional primary care” (family medicine, general internal medicine, pediatric medicine, and geriatric medicine) and approximately 12,000 in various specialties such as emergency medicine, OB/GYNs, and anesthesiologists. The shortage is expected to affect all regions except for Miami-Dade and Monroe Counties, though even these areas may experience uneven distribution of medical professionals.

To combat this impending issue, the report suggests comprehensive strategies like expanded loan forgiveness for physicians working in underserved areas, increasing Graduate Medical Education (GME) positions, and improving the overall practice environment in Florida through measures such as reducing prior authorization burdens, ensuring fair telehealth compensation, and reforming medical malpractice laws to deter baseless lawsuits.


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