A World Where Both Patients and Doctors Are Aging: The Impact of the Imminent "Shortage of 11.1 Million Healthcare Workers"

A World Where Both Patients and Doctors Are Aging: The Impact of the Imminent "Shortage of 11.1 Million Healthcare Workers"

Aging of Those Who Need Medical Care and Those Who Provide It Simultaneously

The world's healthcare is quietly approaching a time-out.

The World Health Organization (WHO) has warned that by 2030, there will be a shortage of approximately 11.1 million doctors, nurses, midwives, and pharmacists worldwide. Currently, more than 70 million people are employed in these professions globally. The number of healthcare workers per 10,000 people has increased from 44.8 to 67.9 over the past two decades.

At first glance, the supply of healthcare personnel seems to be improving. However, another change is occurring beneath the surface. One in four doctors worldwide is over 55 years old, and in high-income countries, the ratio is one in three. Many may reach retirement age within the next decade, while the influx of younger generations is insufficient.

Moreover, it is not only healthcare workers who are aging. Patients requiring treatment and care are also aging. The number of people with multiple chronic illnesses is increasing, complicating the support needed for a single patient, from outpatient visits, medication management, rehabilitation, home healthcare, to end-of-life care.

In other words, the world is about to face a period where "demand increases" and "those responsible for supply leave the field in large numbers" simultaneously. This is the core of the current warning.


An Increase in Numbers Does Not Necessarily Bring Healthcare Closer

The shortage of healthcare personnel is not simply a matter of total numbers.

According to WHO data, the shortage is particularly severe in parts of Africa and the Eastern Mediterranean region. In some African countries, one doctor supports 26,000 people, while in high-income countries, the ratio is about one doctor per 150 people. This disparity is not visible in the average number of doctors worldwide.

The same thing happens domestically. Specialists gather in urban areas, making it difficult to maintain obstetrics, pediatrics, emergency care, and surgery in rural areas. Even if the total number of doctors in a country increases, if there are no people to accept emergency patients at night, provide medical care on remote islands, or visit the elderly at home, healthcare feels distant to the residents.

The shortage also cascades across professions. Even if there are doctors, a lack of nurses means beds cannot be opened. If pharmacists are in short supply, medication support weakens. The absence of lab technicians, radiologic technologists, rehabilitation staff, caregivers, and medical clerks can halt the flow of medical care. It's not just about increasing the number of doctors.

Furthermore, the number of qualified personnel does not match the number who can continue working. If factors such as night shifts, long working hours, infection risks, verbal abuse, harassment, and the difficulty of balancing childcare and caregiving accumulate, even qualified individuals may leave the field. This is why retention rates are more important than recruitment numbers.


For Japan, It's Not a "Future Issue"

In Japan, the number of doctors has been increasing over the long term. According to the Ministry of Health, Labour and Welfare's 2022 statistics, the number of registered doctors exceeds 340,000. However, they are not evenly distributed nationwide, and disparities in medical specialties and regions persist. In areas where the population is declining, the management of medical institutions and on-call systems may become unsustainable before the number of patients decreases.

Japan's peculiarity lies in the simultaneous progression of rapid aging and population decline, even by global standards.

As the elderly population increases, the medical demand per person does not simply decrease. Meanwhile, the working generation responsible for healthcare and caregiving is shrinking. In rural areas, healthcare workers themselves are aging, and more clinics and pharmacies are struggling to find successors. Even in urban areas, if the burden of emergency and inpatient care concentrates on specific hospitals, the field becomes exhausted despite the large number of personnel.

Questions like "Why can't I get an appointment even though there are more doctors?" or "Why can't an emergency transport destination be decided even though there are hospitals?" arise from the discrepancy between total numbers and actual working capacity.

2030 is not a distant future. Training doctors and nurses takes years. Even if educational slots are increased now, it will take more time for them to gain experience and become central figures in regional healthcare. Responding after retirees increase is too late.


Three Prominent Reactions on Social Media

The current report has just been released, and there is no quantitative public opinion survey covering all of social media. Therefore, it is not possible to determine the number or proportion of reactions. However, in posts sharing the report and related discussions about the shortage of healthcare personnel, three main perspectives are observed.

The first reaction is, "Before hiring more, workplaces should be made so that people don't have to quit." Healthcare workers express that attention should be paid to daily burdens such as wages, staffing, night shifts, record-keeping, difficulty taking vacations, and dealing with patients and their families. The concern is that widening the entrance is futile if people cannot continue working, akin to pouring water into a bucket with holes.

The second reaction is the expectation and caution of "How much can AI and digitalization compensate?" Organizing medical interviews, record-keeping, translation, appointment coordination, image diagnosis support, and telemedicine have the potential to reclaim healthcare workers' time. However, AI cannot completely replace tasks like blood sampling, repositioning patients, or addressing patient anxieties. There is a strong concern that using technology as an excuse for personnel reduction will only increase the burden on those who remain.

The third reaction is an ethical concern: "If wealthy countries gather doctors and nurses from abroad, the healthcare of the sending countries will collapse." The right of individuals to cross borders in search of better treatment must be respected. However, if financially capable countries do not bear the cost of human resource development and only absorb fully trained personnel from vulnerable countries, global disparities will widen.

These three perspectives may seem conflicting, but they actually lead to the same question: Should healthcare personnel be treated as an inexhaustible "resource"?


Foreign Personnel Are Necessary, But "Competition" Is Not Sustainable

In Japan, there are high expectations for foreign healthcare and caregiving personnel. Considering the population decline, international mobility of personnel will become even more important in the future. The issue is not simply whether to accept them or not, but under what conditions they are accepted.

In 2010, WHO adopted a code of practice on the international recruitment of health personnel. By 2026, it has strengthened the concept of joint investment, benefiting both sending and receiving countries, and applied it to the caregiving field and emergencies. The idea is to avoid aggressive mass recruitment from countries where healthcare personnel are particularly vulnerable and to incorporate returns to education and healthcare systems when hiring.

If Japan is to accept foreign personnel, merely imposing Japanese language tests and qualification recognition is insufficient. It is necessary to design training costs, family accompaniment, living support, promotion opportunities, discrimination prevention, equal treatment for equal work, and skills development that can be utilized after returning home. Joint investment in schools and hospitals in the sending countries to increase the number of trained personnel is also essential.

The goal is not to stop the movement of personnel but to change it into a cycle where only one side does not benefit. This is the essence of "ethical recruitment."


Solutions Are Not Just About Increasing Training Numbers

Addressing the shortage of healthcare personnel requires advancing at least five measures simultaneously.

The first measure is to reduce turnover. More effective than hiring young people is designing work that allows experienced personnel to remain on site. It is necessary to treat the optimization of night shifts, flexible working hours, balancing childcare and caregiving, organizational responses to violence and harassment, and mental and physical care as healthcare supply policies, not "welfare."

The second measure is job redesign. Safely transferring tasks concentrated on doctors to nurses, pharmacists, paramedics, and clerical staff, and separating tasks that do not require specialized skills, is essential. Task shifting and task sharing, which review the boundaries between professions, are not merely about efficiency but a means to allocate limited expertise to necessary situations.

The third measure is to clarify the purpose of digitalization. Simply introducing electronic medical records and increasing input tasks is meaningless. Achievements should be measured by how many minutes of time are returned to the field through reducing duplicate records, sharing information between facilities, voice input, and optimizing appointments and bed management.

The fourth measure is to reorganize medical functions on a regional basis. Instead of every hospital covering all treatments, it is important to connect emergency, acute, recovery, and home care, and combine online and mobile medical services. For residents, what matters is not preserving the hospital's signboard but being able to access appropriate medical care when needed.

The fifth measure is investment in the demand side. Advancing the prevention of lifestyle diseases, vaccination, prevention of severe illness, medication support, and frailty measures cannot completely resolve the shortage of healthcare workers, but it allows limited personnel to focus on severe cases. Prevention is both a health policy and a human resource policy.


AI Is Not a Substitute for Healthcare Workers, but Can It Increase "Time"?

In discussions about labor shortages, AI is often spoken of as a panacea. However, the real question is not how many jobs AI can replace, but how much time it can free up for healthcare workers to face patients.

AI can be powerful in areas such as drafting medical records, summarizing referral letters, preventing oversights in test results, creating shifts, translation, and assisting with patient explanations. However, specialists are needed to verify errors and make final decisions, and in some cases, work may initially increase after introduction. If tools are added without changing the workflow, it will only increase screens and notifications.

Moreover, if face-to-face medical care is uniformly reduced due to labor shortages, elderly or disabled individuals, foreigners, and regions with weak communication infrastructure may be left behind. Technology can be designed to either narrow or widen access disparities.


From "How Many People Are There" to "How Much Care Can Be Delivered"

The WHO's warning is not merely to fear the enormous figure of 11.1 million.

The era of measuring the strength of healthcare systems solely by the total number of qualified personnel is ending. What matters is where these individuals are, which professions they collaborate with, how many hours they can work, how many years they remain on site, and how much safe care they can deliver to residents.

Japan is a country facing the "double aging" of patients and healthcare workers ahead of the world. In that sense, this warning is not foreign news but a mirror reflecting Japan's near future.

Encouraging young people to pursue healthcare professions is not enough. A system is needed where experienced personnel do not burn out, those raising children can easily return, elderly specialists can pass on their knowledge without strain, and foreign personnel can work as equal professionals. Additionally, systems and technologies are required to focus time on tasks that only healthcare professionals can perform.

Even if hospital buildings and the latest equipment remain, healthcare cannot be delivered without people to operate them. The key to avoiding the crisis of 2030 lies not only in increasing the number of people but in transforming healthcare into one where people can remain, grow, and exert their abilities.


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