HRSA HWSM FY2025 · 2023 → 2038

By 2035, the US faces a shortfall of at least 52,430 physician FTEs in metro areas alone.

This is HRSA's own status-quo projection — the number rarely quoted in headlines. Layer on clinical need, staffing realities, and AI-driven demand growth and the gap widens substantially.

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The gap is much larger than the headline

2035 physician shortfall by scenario

HRSA Status Quo

−52,430

HRSA's published 2025 projection: demand extrapolates observed utilization. 2035 demand = 983,500, supply = 931,070.

HRSA Improved Access

−176,540

HRSA's own Combination scenario — what demand would be if everyone had metro, insured, non-Hispanic-white utilization rates.

Our Full Extension (E1+S1+S3)

Live

−352,720

All our current L2 extensions at literature defaults: need-based demand (E1), AI productivity (S1), mandatory staffing ratios (S3). Live from the scenario engine.

Why HRSA's headline understates the gap

Demand ≠ need

HRSA defines demand as 'services that will be utilized given patient health-seeking behavior, and ability and willingness to pay'. Their own technical documentation states 'demand is different from need.'

Scenario space is too narrow

Zero HRSA scenarios model AI productivity, scope-of-practice shifts, mandatory staffing ratios, team-based care, or telehealth capacity effects. We add 14 extension knobs.

Financial impact is missing

HRSA publishes FTE counts, not dollars or health outcomes. Our Layer 3 translates shortages into revenue loss, preventable admissions, and GDP drag.

Explore the platform

Three interactive layers. Partners usually start with the Scenario Builder to stress-test assumptions, then jump to Financial Impact for the dollar translation.

Start here

Scenario Builder

Stack 14 extension knobs — need-based demand, AI productivity, staffing ratios — on top of HRSA's baseline. Live waterfall shows each knob's contribution.

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Dollar translation

Financial Impact

FTE shortages → health-system P&L, preventable admits, life-years lost, GDP drag. Per-state breakdown + archetype switch + sensitivity tornado.

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State-level adequacy

US State Map

Choropleth of supply ÷ demand by state, year, and profession. Hover any state for supply, demand, and shortage rank.

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All 14 scenarios

HRSA Scenario Comparison

Layered line chart of every HRSA scenario HRSA publishes for any profession — from Status Quo to Elevated Need, with plain-English legends.

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~120 occupations

Profession Catalog

Browse every occupation HRSA publishes. Each entry links to a data sheet with metadata, scenario matrix, and a shortcut into the Scenario Builder.

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Narrative view

Policy Brief

A short, citation-backed narrative explaining why HRSA's headline understates the gap. Good for client deck footnotes.

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Full transparency

Methodology & Sources

HRSA's HWSM technical documentation summary, our extension derivations, and the full citation list.

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Validation layer

HRSA Parity Check

Cell-by-cell proof that our Layer 1 matches HRSA's published XLSX. Spot-check any (profession, state, scenario, year) tuple.

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