Physician shortages are driving access to care concerns and our industry needs to respond. Delays in specialty referrals are creating patient frustration and driving up lost time and claim durations. Long waits in clinics are driving down productivity and exacerbating patient frustration. This issue doesn't just affect injured workers who rely on timely medical evaluations and treatment; it has broader implications for employers, insurers, and the healthcare system as a whole.
Understanding the reasons behind this shortage can help us explore potential solutions and adapt to the evolving circumstances.
Physician Growth v. Population Growth
The overall healthcare system has not kept up with the replacement rate for retiring physicians. In 1980, the US population was approximately 226 million, and we issued around 17,000 new MD diplomas. By 2000, the US population had risen to 280 million people, and we added roughly 18,000 new MD diplomas. Over two decades, the population grew by 24.5% and we added exactly zero new medical schools. In the time since, new schools have begun opening, but the systemic impact of these 20 years is just now starting to affect all of US healthcare as retirees outstrip new entrants.
Difficulties in Workers’ Compensation
Where the entire system suffers from an insufficient number of providers, workers’ compensation feels the shortage far worse. The additional administrative burden can deter physicians from participating in the workers' compensation system, making it less appealing compared to other areas of practice where they can focus more on patient care and less on administrative tasks. Specialists resist workers’ compensation for various reasons. However, those who do participate often struggle due to their EMR systems not being configured for workers’ compensation forms and billing formats. Furthermore, their limited understanding of the complexity of UR and eligibility processes frequently leads to rejected bills.
The perception of workers' compensation as a challenging field is compounded by the nature of the cases involved. Physicians working in this area often face scrutiny and potential legal disputes surrounding the treatment and evaluation of injured workers. Such cases can lead to stress and burnout, further discouraging new doctors from entering or staying in the field. The complicated interplay of medicine, law, and insurance can create an environment that feels less rewarding compared to traditional medical specialties, ultimately discouraging participation.
A Positive Trend
From 1990 to 2025, the number of DO schools in the United States grew from 15 schools to 43 schools. Starting in the early 1970s, these programs aligned their educational standards with the MD Liaison Committee on Medical Education, which has made their degree interchangeable with MD degrees in most medical specialties. This is particularly positive for Occupational Medicine, where the Osteopathic emphasis on physical medicine aligns exceptionally well with our patient population.
Today, the United States is home to roughly 350 million people. We added 19,700 new MD graduates and 8,195 DO graduates in 2024, showing some improvement, but still lagging behind population growth.
What Does This Mean For You?
Given these challenges, it is vital to identify possibilities for improving the situation. One approach might involve simplifying administrative processes to make it easier for doctors to participate in workers' compensation cases.
- Managed Care needs to evolve and find ways to streamline paperwork and help doctors help us. An overall shift toward better support can encourage more physicians to engage with this area. At EK Health, we are deploying systems that accelerate appropriate care and streamline the ability to identify when care is going off track.
- Networks need to evolve from lowest bidder medicine to arrangements that provide better partnership and access to care. Our Provider Alliance PPO and outcomes-based managed care networks place a higher emphasis on timely access to care and effective engagement when resolving issues.
- The workers’ compensation industry as a whole needs to examine which cost savings initiatives are sacrificing long-term participation for short-term gains. By reimagining the role of managed care, we can drive better resolution with less frictional costs. Programs like exclusive networks (MPN, HCN, PPP) need to add value beyond rejecting out-of-network claims if that behavior is preventing a good specialist from taking any future referrals. These programs are important tools to contain care and they have to be appropriately managed and developed responsibly with the goals of facilitating better care.
The shortage of doctors in workers' compensation is a complex issue. By acknowledging these challenges and taking proactive steps towards solutions, we can work to ensure that injured workers receive the medical attention they need and deserve. This, in turn, will help sustain the integrity and effectiveness of the workers' compensation system.