ABSTRACT There are 1,018,776 licensed physicians in the United States and the District of Columbia, representing a physician workforce that is 20% larger than it was a decade ago, according to data from 2020 compiled by the Federation of State Medical Boards (FSMB). The licensed physician population has grown in number relative to the total population, but concerns about a doctor shortage remain as both the general and physician populations age. Late career physicians generally work fewer hours and retire at higher rates, while younger physicians place more emphasis on work-life balance that may also limit work hours, even as many older physicians have delayed retirement in recent years. The mean age of licensed physicians is now 51.7 years, a year higher than it was in 2010. The physician workforce is increasingly mixed in gender and type of physician, with more women and more individuals with Doctor of Osteopathic Medicine (DO) degrees, specialty board certification and international medical degrees than a decade ago. The ability to inventory a nation’s health care workforce across all specialties and jurisdictions is essential to the delivery of quality health care where it is needed most. This paper marks the FSMB’s sixth biennial census of licensed physicians in the United States and the District of Columbia and provides valuable information about the nation’s available physician workforce, including information about medical degree type, location of undergraduate medical education, specialty certification, number of active licenses, age and sex. As the impact of the COVID-19 pandemic on the United States is not yet fully known, this report should help state medical boards as they consider changes to their statutes and regulations to facilitate telemedicine and licensure portability after the pandemic ends and before another national public health emergency.

ABSTRACT This article considers concerns about the presence and phrasing of questions on physician licensing applications related to mental health, substance abuse, and leave from practice. These questions may discourage physicians from seeking appropriate treatment due to fear of stigmatization, public disclosure, and career effects related to licensing or credentialing concerns. Accessible and affordable resources and programs are needed to allow physicians to seek treatment in a non-punitive, confidential manner. The authors discuss how some state medical boards have taken steps to address barriers that prevent licensees from seeking help and review the work of the Federation of State Medical Boards Workgroup on Physician Wellness and Burnout, which addressed concerns about physician wellness, burnout, and suicide prevention. Physician health programs also have begun to intervene in areas related to mental and physical health and are providing confidential and professional support. Additionally, medical schools, hospitals, and medical societies have increased their focus on mental health by implementing programs and offering resources to help students and physicians improve their overall health. Raising awareness about the importance of physician wellness has inherent value to physicians and the public and ultimately contributes to patient safety and the health of our nation.

ABSTRACT There are 985,026 physicians with Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees licensed to practice medicine in the United States and the District of Columbia, according to physician census data compiled by the Federation of State Medical Boards (FSMB). These qualified physicians graduated from 2,089 medical schools in 167 countries and are available to serve a U.S. national population of 327,167,434. While the percentage of physicians who are international medical graduates have remained relatively stable over the last eight years, the percentage of physicians who are women, possess a DO degree, have three or more licenses, or are graduates of a medical school in the Caribbean have increased by varying degrees during that same period. This report marks the fifth biennial physician census that the FSMB has published, highlighting key characteristics of the nation's available physician workforce, including numbers of licensees by geographic region and state, type of medical degree, location of medical school, age, gender, specialty certification and number of active licenses per physician. The number of licensed physicians in the United States has been growing steadily, due in part to an expansion in the number of medical schools and students during the past two decades, even as concerns of a physician shortage to meet health care demands persist. The average age of licensed physicians continues to increase, and more licensed physicians appear to be specialty certified, though the latter finding may reflect more comprehensive reporting. This census was compiled using the FSMB's Physician Data Center (PDC), which collects, collates and analyzes physician data directly from the nation's state medical and osteopathic boards and is uniquely positioned to provide a comprehensive snapshot of information about licensed physicians. A periodic national census of this type offers useful demographic and licensure information about the available physician workforce that may be useful to policy makers, researchers and related health care organizations to better understand and address the nation's health care needs.

An accurate understanding of the demographic and state medical licensure characteristics of physicians in the United States is critical for health care workforce planning. Overall changes in the nation's population demographics, state and federal medical regulatory policies and dynamics surrounding the ongoing health care reform debate further highlight the need to have an up-to-date census of actively licensed physicians across all medical specialties. This article uses data received by the Federation of State Medical Boards (FSMB) from the nation's state medical and osteopathic licensing boards to report and summarize key features of actively licensed physicians in the United States and the District of Columbia. Our biennial census, current through the end of 2016, identifies a total of 953,695 actively licensed allopathic and osteopathic physicians serving a national population of 323 million people. This represents a net physician-increase of 12% from the 2010 census. From 2010 to 2016, the actively licensed U.S. physician-to-population ratio increased from 277 physicians per 100,000-population to 295 physicians per 100,000-population. Females now make up one-third of all licensed physicians, with osteopathic physicians and Caribbean medical graduates continuing to demonstrate substantial increases in both their absolute numbers and as a percentage of all actively licensed physicians from the 2010 to 2016 time period.

The medical profession has seen significant advancement in the availability of a variety of educational activities, across a range of formats and processes, to help physicians remain current and improve professional performance. The objectivity and quality of continuing medical education (CME) activities has been enhanced by the credit recognition systems of the American Academy of Family Physicians (AAFP), the American Medical Association (AMA), and the American Osteopathic Association (AOA). These credit systems also provide a metric for tracking compliance with a variety of regulatory requirements such as state medical licensure, hospital staff privileges, and health insurance plan participation, and are increasingly used as criteria for voluntarily obtaining and maintaining specialty certification and fulfilling requirements for membership in medical specialty societies. This article reviews the history of CME, the research that supports its value, and the opportunities that exist to address its challenges. It also explains how the Federation of State Medical Boards (FSMB) Maintenance of Licensure (MOL) framework incorporates and builds upon the research involving the effectiveness of CME for physician learning and improvement. Special focus is given to the CME credit systems and their features, the synergies among them, and the way in which various learning formats that can be certified for CME credit are aligned with the three recommended components of MOL.

Marked changes have occurred in health care delivery in the United States with the implementation of the Affordable Care Act (ACA), including the advancement of integrated health systems, the introduction of patient centered medical homes and the creation of accountable care organizations. With millions of Americans newly insured, never has there been a more pressing need for accurate physician workforce information and planning. Opinions vary about the nature and degree of anticipated physician shortages, and health care workforce determinations are fraught with variables and uncertainties that are challenging to address definitively. Identifying accurate information about the nation's currently licensed physician workforce, however, is an important starting point. This article reviews data received in 2014 by the Federation of State Medical Boards from the nation's state medical and osteopathic boards about the current supply of actively licensed physicians in the United States and the District of Columbia. Our census data demonstrates the total population of licensed physicians (916,264) has increased by 4% since 2012, and the nation, on average, added 12,168 more licensed physicians annually than it lost. The average physician is now older (by a year), predominantly male (but increasingly female at entry level) and increasingly a graduate of a medical school in the Caribbean. Meanwhile, the percentage of physicians with a single state medical license has remained constant at 79%.

ABSTRACT The Patient Protection and Affordable Care Act, signed into law in 2010 and upheld by the U.S. Supreme Court last year, is expected to provide health care coverage to as many as 32 million Americans by 2019. As demand for health care expands, the need for accurate data about the current and future physician workforce will remain paramount. This census of actively licensed physicians in the United States and the District of Columbia represents data received from state medical boards in 2012 by the Federation of State Medical Boards. It demonstrates that the total population of licensed physicians (878,194) has expanded by 3% since 2010, is slightly older, has more women, and includes a substantive increase in physicians who graduated from a medical school in the Caribbean. As state medical boards begin to collect a Minimum Data Set about practicing physicians and their practice patterns in the years ahead, this information will inform decisions by policymakers, regulators and health care market participants to better align health care demand with supply.

ABSTRACT Fulfilling a statutory responsibility to protect the public within their jurisdictions, state medical boards have been working with the Federation of State Medical Boards (FSMB) and collaborating organizations to thoughtfully explore pathways and procedures by which Maintenance of Licensure (MOL) may be implemented for physicians in the years ahead. As a better understanding emerges of the types of continuing medical education (CME) and continuous professional development (CPD) activities physicians already engage in, and the resources that may be necessary for state boards to meaningfully implement MOL, questions have sometimes arisen about the value of these activities in contributing to quality health care and improved patient outcomes. Though MOL has not yet been formally implemented, there is a growing body of compelling evidence and rationale for the educational activities that could meet a state board's requirements for MOL. This article summarizes the recent literature on the subject, including CME and CPD, and recent policy statements of organizations and thought leaders from the house of medicine.

ABSTRACT The Federation of State Medical Boards celebrated its centennial anniversary in 2012. In honor of this milestone, the Journal of Medical Regulation offers the fourth in a series of articles presenting the history of the FSMB within the context of the growth of America's medical regulatory system. These articles are adapted from Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards now available from Lexington Books, a subsidiary of Rowman and Littlefield Publishing Group.

The Federation of State Medical Boards celebrates its centennial anniversary in 2012. In honor of this milestone, the Journal of Medical Regulation offers the third in a series of articles presenting the history of the FSMB within the context of the growth of America's medical regulatory system. These articles are adapted from Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards now available from Lexington Books, a subsidiary of Rowman and Littlefield Publishing Group.

ABSTRACT The Federation of State Medical Boards celebrates its centennial anniversary in 2012. In honor of this milestone, the Journal of Medical Regulation offers the second in a series of articles presenting the history of the FSMB within the context of the growth of America's medical regulatory system. These articles are adapted from the forthcoming Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards set for release in September 2012 by Lexington Books, a subsidiary of Rowman and Littlefield Publishing Group.

ABSTRACT The Federation of State Medical Boards celebrates its centennial anniversary in 2012. In honor of this milestone, the Journal of Medical Regulation offers the first in a series of articles presenting the history of the FSMB within the context of the growth of America's medical regulatory system. These articles are adapted from Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards , set for release later this year by Lexington Books, a subsidiary of Rowman and Littlefield Publishing Group.

ABSTRACT As part of their ongoing effort to protect the public, the nation's 70 state and territorial medical and osteopathic boards regularly collect and disseminate information about actively licensed physicians in their jurisdictions to the FSMB's Federation Physician Data Center. This article summarizes results from the first-ever comprehensive analysis by FSMB of this information, from state boards and additional sources, to present a census of actively licensed physicians in the United States and the District of Columbia in 2010. While noting the value to state boards and multiple stakeholders of an accurate count of physicians — including information about their gender, age, specialty certification and location by region — the article acknowledges opportunities for future collaboration among organizations and agencies to better define current physician supply in order to better predict future physician needs for a growing and aging national population.

IN BRIEF The authors describe a system in which physicians periodically demonstrate ongoing clinical competence as a condition of license renewal.