Part 2 of our analysis of Black Physicians in the US
What are the roots of the Black doctor shortage?
There is a real shortage of Black doctors in the United States. The lack of Black doctors reduces Black health and life expectancy. Black people live longer when treated by Black physicians. The effect of Black doctors on improving Black healthcare outcomes is well-documented. But this article is a little different. We want to take a detailed look at the data on the number of black doctors and the data behind the black doctor shortage. We have a separate post on solutions to increasing he number of Black physicians.
Many other media outlets have covered the Black doctor shortage. CNN, Time, and the Amsterdam News. The impact on Black healthcare has been studied widely. But where does the African American physician deficit come from? We are going to analyze the reasons for the low number of black doctors in the article.
Blackeconomics.com estimates the number of missing black doctors at 60,000. Please read our calculations below.
There is an important and unseen economic impact. The impact is threefold: One is the missing black income from missing Black physicians, the second is the consumer sending impact of the missing income, and the third is the opportunity impact. The number of missing African American physicians would have contributed an additional $80 million to black income. That is just a one-year estimate. Over a physician’s lifetime we are talking about close to a $1 trillion dollars.
There are currently about 75,000 Black physicians in the US. African Americans are 14% of the population, but only 6.7% of physicians. Since 1970, the number of African American doctors has increased from 6,106 to 75,000 by 2024. The number increased by 1,100% (11 times the number from 1970) in 2024. The progress has been magnificent. But Black life expectancy lags all other groups.
But progress has stalled since 2015. The number of Black applicants and Black medical school graduates has stagnated in the past 10 years. There are many reasons for the small increase in African American physicians: the high cost of medical education, the small increase in the Black applicant pool, the elimination of affirmative action and DEI programs, and increased competition from other ethnic groups and foreign doctors.
The shortage of Black doctors is a complicated problem. It is caused by historic discrimination in the US in education. Physicians require a huge amount of scientific knowledge.
The number of missing Black physicians
We calculate the number of missing Black physicians at 60,000 doctors. Sadly, the number is close to the number of Black physicians in the US: 75,000. The number of Black doctors should be 80% higher, or about 135,000 Black physicians. The US missed a tremendous opportunity in healthcare by not educating more Black doctors and nurses during Jim Crow. It took the Civil Rights Movement and the Feminist movement to start to address the shortage. Black health has suffered. Black life expectancy has been cut short.
Like everything else we discuss at BlackEconomics.com, the Black physician shortage is complex and detailed, so we have to dig in deeper and do some analysis. We are not going to gloss over the details with a big headline number and move on. Instead, we are going to take a more comprehensive look at the components of the black doctor shortage and analyze the outcomes.
Our hope is to inspire additional research into the problem. And offer solutions to the Black doctor shortage.
Let’s break down the Black doctor shortage
There are three main components to the Black doctor shortage: a shortage of Black doctors compared to the general population, a general shortage of doctors compared to other countries, and a “Missing Black Doctor” problem due to historic discrimination.
The current Black doctor shortage represents the effects of discrimination in society from the 1900s to the present day, especially in education. The shortage also encompasses a larger problem hidden within the African American doctor gap: The “Missing Black Doctor Problem” (MBDP). There is a large number of missing African American physicians due to historical racism, discrimination, and sexism in society. Black people, especially women, were simply not allowed to become doctors.
We can calculate the shortage of Black physicians as compared to the general Black population relatively easily. The good news is the gap is closing. The bad news is that progress has stalled, lately due to the elimination of affirmative action programs and attacks on diversity, equity, and inclusion programs. However, as an economics blog, the Missing Black Doctors (MBD) problem is the most interesting.
The number of missing Black physicians because of historical discrimination can be further broken down into four more pieces: the forced closure of Black medical schools during the early 19th century, limits on access to white medical schools, the rampant sexism that limited the opportunities for women to become physicians, and the poor quality of education available to African Americans at the time.
The black doctor shortage in the media
The African American doctor shortage has received a large amount of coverage in the media. Time Magazine has a great story on the history of the Black doctor shortage. The story boils down to just straight-up racism in society during the early years of organized medicine. The article highlights the Flexner Report, which aimed to professionalize medical education but instead shut down Black medical schools, reinforcing white economic power in medicine.
The Amsterdam News covers the topic and includes an interview with Dr. David Carlisle. He discussed how to get more African Americans interested in medical careers.
The Journal of the American Medical Association has an excellent article about missing Black doctors (JAMA). They estimate there should be 10,000 to 30,000 more Black doctors if Black medical schools had not been forced to close during the early 1900s.
Details of the Black Physician Shortage
We are now going to break down the components of the Black doctor shortage. Then we will look at the number of missing Black doctors.
First, there is a real shortage of Black doctors in absolute terms. When you compare the number of Black physicians to the general Black population. The number of physicians is about 1.1 million, while the number of Black physicians, as previously calculated, is 75,000. That is a rate of 6.8%.
There are 41 million Black people in the United States in 2024, while the general population is 340 million people. African Americans are 14.4% of the population, while about 7.0% of physicians are Black. If the number of doctors matched the general Black population(14%), there would be an additional 75,000 Black doctors based on population alone.
This basic figure sums up all the other categories that have caused the Black doctor shortage.
Second, there is a general shortage of physicians in the US. AAMC projects a shortage of 86,000 doctors by 2036. The shortage impacts the health of all patients in the US.
There is a general shortage of doctors in the US compared to other countries with better life expectancies and health outcomes (KKF). The US had 1,010,892 physicians in 2024 according to the AAMC. The US has a physician (??? Health care provider rate) rate of 2.6% per 1000.
If the US had a rate similar to many countries in Europe, 3.5% or even the 3.0% level, then the number of doctors would increase by 34% and 15%, respectively. Or, in actual numbers, an additional 350,000(350K) doctors at the 34% level and 156K at the 15% level.
Then, doing the math, we can calculate the number of additional Black doctors. If 7% of physicians are Black, then the overall increase equates to about 11,000 more Black doctors.
There are many reasons why the US has fewer doctors than a typical “Western” country. The United States has fewer medical schools, existing medical schools limit admissions, the high cost of medical education, and doctors seeking higher pay.
Basically, the US does not prioritize healthcare. The per capita number of doctors is lower than other western democracies.
Missing Black Doctors due to historical discrimination
Third, there is a large “missing Black doctor problem” due to historical discrimination. Education was largely unavailable to African Americans. The black literacy rate in 1910 was XXX
Black medical schools were closed during the 1910s
In 1910, Abraham Flexner issued a report to the Carnegie Foundation. The report titled “Medical education in the US and Canada,” was a landmark review of medical education. It was the time of low-quality medical education, snake-oil salesmen, and homemade remedies. Flexner recommended professionalizing medical education, a science-based undergraduate education, and reducing the number of medical schools.
The issuing of Flexner report in 1910, was a defining moment in US medical education. The report led to the closing of 5-13 Black medical schools during the 1900-1920s. In addition, no new Black medical school opened between 1920 and 1987, when the Morehouse School of Medicine opened. Later the Drew-King school of medicine opened in California.
If Black medical schools had continued and grown, there would be an additional 10,000 to 30,000 Black doctors, all with the benefits. And if HBCUs opened additional medical schools at a rate similar to white schools, the number of African American physicians would have increased dramatically.
The Journal of the American Medical Association has an excellent article about missing Black doctors (JAMA). They estimate there should be 10,000 to 30,000 more Black doctors if Black medical schools had not been forced to close during the early 1900s.
Access to white medical schools was limited
Research topic: Black graduation rates at white institutions
Rampant discrimination against Female doctors during Jim Crow and later
Finally, there was severe discrimination against women becoming doctors during the Jim Crow era and later, even after the civil rights movement. The women’s equality movement came about 20 years later. It was only during the 1980s that women made significant gains as physicians.
In the year 2024, women are 40% of all doctors and 50% of Black doctors. <<<source, and data>>
It is impossible to calculate the missing Black female doctors but we are going to try using available data.
Our equation to estimate the number of missing Black physicians
Here we try to do the math. We want to estimate the number of Missing Black Doctors in the US in 2025.
The number of missing black doctors is equal to the number of Missing doctors due to Black medical school closures, plus missing Black doctors due to discrimination in White medical schools, plus missing Black doctors due to sexism, plus missing Black doctors due to limited education and preparation at the time, plus limited opportunity due to discrimination in society at the time.
Education is tricky, but it is the core of the problem. Blacks had limited access to educational and scientific education during Jim Crow era. There was no opportunity for pre-medical education in inferior schools. Schools emphasized vocational training, not science and philosophy. And people who were qualified, such roots medicine doctors, healers and nurses could not meet the qualifications. Education is important enough to be included in the missing Black doctor equation.
Opportunity is also difficult because the effects are diffuse and speculative. How many nurses, teachers, scientists and government workers could have become doctors with the right circumstances? We will never know.
The number of missing Black doctors is alarming:
We can do a quick estimate based on general population numbers. There are 75,000 Black physicians or about 7% of the total number of physicians in the US (1,100,000). African Americans are about 14% of the US population, so if they were 14% of doctors there would be an additional 75,000 more Black physicians. We assume this number captures the sum of all the other missing doctor categories except physician employment levels outside the US.
We can further break down the number of missing Black doctors due to different effects in our political economy.
We are missing 20,000 (somewhere between 10,000 to 30,000) due to the closing of Black medical schools. Existing Black medical schools could not expand due to financial reasons.
We are missing 10,000 due to discrimination at white medical schools. We estimate there would be about 10,000 additional Black doctors practicing if white medical schools admitted Black students between 1920 and 1970 at roughly half the current rate of 6% in 2020. The same for Black women.
We are missing 20,000 (somewhere between 10,000 to 20,000) due to sexism in the medical field. This one is the most damaging. It is important to remember that times were different and that many women became doctors or worked as homemakers.
Unknown. Poor education. This is the “pipeline” problem. Black people were not educated at the same rate as whites, and the quality of education was poor. Blacks were not prepared for medical school due to inferior schools and educational opportunities
10,000 – Opportunity effects. Unknown. This measure captures Black role models, mentors, and family and institutional knowledge. It also records Blacks who would otherwise make great candidates for medicine, but choose careers elsewhere, such as government, nursing, or education.
Finally, we are missing 11,000 to 25,000 due to poor healthcare in the US. The number of doctors per capita is higher in European countries. We will not include this number in our missing doctors estimate.
Numerical estimate of missing Black doctors
So, our estimate of missing Black doctors is: 20,000 (missing Black medical schools) + 10,000 (for white medical school discrimination) + 20,000 for sexism + 10,000 (for education and opportunity effects) = 60,000 missing Black doctors.
That’s an estimated 60,000 missing Black doctors. Very close to the current 75,000 African American physician estimates using the general population.
Summary
We calculate the number of missing Black doctors at 60,000. Sadly, the number is close to the number of Black physicians in the US: 75,000. The number of Black doctors should be 80% higher, or about 135,000 Black physicians.
We also calculate the missing Black income. Over a $1 trillion dollars is missing. The US missed a tremendous opportunity in healthcare by not educating more Black doctors and nurses during Jim Crow. It took the Civil Rights Movement and the Feminist movement to start to address the shortage. Black health has suffered. Black life expectancy has been cut short.
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