One of the challenges to retention in many health professions is the aging of the workforce itself. As of January 2007, 23.3 percent of all active physicians were 60 or older (AAMC, 2007a), and by 2020 almost half of all registered nurses are expected to be over age 50 (AHA, 2007; Buerhaus et al., 2000). Large numbers of health care workers are also expected to retire just as the need for services increases. For example, more dentists are retiring now than are entering practice (Center for Health Workforce Studies, 2005). Based on current trajectories, many health professions will struggle just to replace the current workforce and will not be able to meet increases in demand.
Overall, the committee recognized the difficulty and inaccuracy associated with attempting to predict specific numbers of future health care workforce supplies. Instead, the committee chose to present some previously reported predictions of shortages in an attempt to highlight the relative scale of the needed increases in workers rather than determine a specific number needed for every profession. Box 1-1 highlights just a few of the current and future shortages.
Discussions of health care workforce shortages often focus solely on professionals,2 but direct-care workers (i.e., nursing assistants, home health aides, and personal- and home-care aides) warrant at least equal consider-