Forecasting the physical medicine and rehabilitation workforce through 2037: National and geographic disparities in supply and demand.

BACKGROUND

Physical medicine and rehabilitation (PM&R) physicians manage patients with complex functional impairments due to stroke, spinal cord injury, traumatic brain injury, congenital conditions, progressive neurological disorders, and chronic musculoskeletal conditions. These patients often require long-term, resource-intensive care. However, long-term projections of the national physiatry workforce remain limited, and existing estimates do not account for access disparities.

OBJECTIVE

To forecast national and geographic trends in PM&R workforce supply, demand, and adequacy through 2037, under current and expanded access scenarios.

DESIGN

Forecasting analysis using the Health Workforce Simulation Model, developed by the National Center for Health Workforce Analysis, and publicly available federal datasets.

SETTING

National and state-level workforce projections in the United States.

PARTICIPANTS

Not applicable.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE(S): Projected national and state-level workforce adequacy, defined as the ratio of supply to demand in full-time equivalents (FTEs), from 2022 to 2037 under status quo and reduced barriers scenarios.

RESULTS

From 2022 to 2037, PM&R supply is projected to increase 10.6%, rising from 11,660 to 12,830 FTEs. Over the same period, demand increases by 8.1% under the status quo scenario (12,780 to 13,820 FTEs) but reaches 18,060 FTEs under the reduced barriers scenario. National adequacy improves slightly under the status quo (91% to 93%) but remains flat under reduced barriers (71%). Metropolitan areas maintain higher adequacy than nonmetroplitan areas, which remain severely underserved. State-level projections show persistent disparities, with adequacy ranging from 29% in West Virginia to 200% in the District of Columbia. By 2037, PM&R ranks 13th in adequacy under the status quo and 25th under reduced barriers among 37 specialties.

CONCLUSIONS

Workforce projections suggest persistent and uneven shortages in PM&R, particularly in nonmetropolitan regions and under scenarios of expanded access. Strategic efforts to expand training capacity and improve geographic distribution are warranted to meet future rehabilitation care needs.