The physician and the next decade
The EU is short of 1.2 million health professionals. Do you already know what will set you apart?
Twenty EU countries have reported a shortage of doctors, and more than a third of those practising retire within the decade. The arithmetic that sustained practices for thirty years has stopped working.
Free business assessmentSource: OECD and European Commission, Health at a Glance: Europe 2024
The numbers
What the data says — and where it comes from.
Every figure below comes from the Demografia Médica no Brasil 2025, led by FMUSP together with AMB, the Brazilian Ministry of Health, PAHO, MEC and FAPESP. IBGE enters only as the source of the population census.
| Indicator | Value | Note |
|---|---|---|
| 636,000 | doctors in practice in Brazil | projection for the end of 2025 |
| 1.15 million | doctors projected for 2035 | an 81% rise in ten years |
| 2.98 → 5.25 | doctors per thousand people | 2025 → 2035 |
| 448 | medical schools in the country | there were 252 ten years ago |
| 48,491 | undergraduate places a year | 79.3% at private institutions |
| 32,611 × 16,189 | graduates against residency places | 2023–2024 cycle |
| 244,000 | generalist doctors | there were 153,800 in 2018 |
| 58% | of doctors practise in 48 municipalities | cities of more than 500,000 people |
| 44.8 → 40.8 | average age of the Brazilian doctor | 2024 → 2035 |
Source: Demografia Médica no Brasil 2025 — coordinated by Prof. Mário Scheffer (Department of Preventive Medicine, FMUSP). Updated July 2026.
The arithmetic
More doctors competing for the same patients.
The supply of doctors grows far faster than the population. Drag the horizon and watch what that does to competition per patient.
- Doctors in Brazil
- 1,151,160
- Competition per patient, against 2025
- +64%
In 2035, for every patient who today chooses from a handful of doctors, there will be 64% more professionals competing for the same attention — without demand growing at anything like that pace.
How we read this: it is the national aggregate — supply of doctors (+81% by 2035) over population growth (~1% a year). Real competition varies by specialty and by city, a cross-section the Demografia Médica no Brasil 2025 does not yet publish. We don't estimate what we don't have.
The turning point
Where word of mouth stops working.
For thirty years, referrals were enough. The patient left satisfied, told two others, and the diary held itself up. It worked because the arithmetic worked: few doctors, plenty of demand, a town small enough for a name to travel.
None of those three conditions still holds. The number of doctors is heading towards 1.15 million, the patient's choice has moved to online search, and the competition stopped being the colleague around the corner. Word of mouth didn't die — it stopped being sufficient.
You won't be competing on being the better doctor. That you already are. You'll be competing on being found, chosen and remembered — three things nobody taught at residency.
What changes in practice
Marketing as infrastructure, not advertising.
Marketing done well doesn't fill the diary with just any patient. It delivers predictability — and predictability is what hands choice back to the doctor.
Diary
Predictability instead of full months followed by empty ones.
Income
Being able to turn down the insurer that pays badly, because the diary doesn't depend on it.
Autonomy
Charging what the work is worth, without taking on-call shifts to close the month.
Choice
Attracting the right patient for your specialty, not just any patient.
Within the rules
Medical marketing is allowed — with limits the ordinary agency ignores.
CFM Resolution No. 2.336/2023 — issued by Brazil's Federal Council of Medicine, in force since March 2024 — modernised medical advertising and widened what a doctor may do. But it kept lines that, once crossed, expose the professional to ethics proceedings. Marketing for healthcare is, above all, marketing that knows those lines.
What the resolution allows
- Publicising your work on social media, without sensationalism
- Showing the practice's rooms and equipment
- Stating consultation prices, payment options and opening hours
- Presenting verifiable results, without identifying patients
What remains forbidden
- Guaranteeing, promising or implying treatment results
- Sensationalism, self-promotion and unfair competition
- Showing images of consultations or procedures in progress
- Publicising methods not recognised by the CFM
Every piece of advertising must carry the doctor's name, the CRM registration number and, for specialists, the RQE. Respecting those rules is what protects a practice's reputation as it grows — and it is why no PRIOS page promises patient numbers or revenue.
Reference: CFM Resolution No. 2.336/2023. This content is informational and does not replace legal advice.
Frequently asked questions
What the Brazilian doctor asks.
The Demografia Médica figures and the CFM rules, answered straight.
How many doctors are there in Brazil today?
Brazil has around 636,000 doctors in practice, according to the Demografia Médica no Brasil 2025 projection for the end of 2025. The study is led by FMUSP together with AMB, the Brazilian Ministry of Health, PAHO, MEC and FAPESP.
How many doctors will Brazil have in 2035?
The projection is 1.15 million doctors in 2035 — an 81% rise in ten years, according to Demografia Médica no Brasil 2025. Over the same period the population grows about 1% a year, far below the pace at which doctors are being added.
Why is the number of doctors growing so fast?
Because the number of medical schools jumped from 252 to 448 in ten years, with 48,491 undergraduate places a year, 79.3% of them at private institutions. Training accelerated far beyond population growth.
Does the CFM allow medical marketing?
Yes. CFM Resolution No. 2.336/2023, in force since March 2024, lets a doctor publicise their work, show their practice and state prices and opening hours. What is forbidden is guaranteeing or implying results, sensationalism and unfair competition. The CFM is Brazil's Federal Council of Medicine, and its rules apply there only.
Does it work for a newly qualified doctor?
Yes. It is precisely those starting out who compete for space in a market projected to have almost twice as many doctors by 2035. Structuring presence and patient acquisition early is what builds a predictable diary before the competition tightens.
Latin America
Latin America doesn't just need more doctors. It needs to turn technology into access.
- 600,000
- doctors, nurses and midwives missing by 2030, against the target of 44.5 per 10,000 people
- 2 million
- professionals needed by 2030 for 80% effective coverage — this figure also counts dentistry and pharmacy
- 3.7% of GDP
- public spending on health in the region, against a regional commitment of 6%
- almost 1/3
- of total health spending is paid out of pocket by households — the recommended ceiling is 20%
Fonte: PAHO
Fonte: PAHO
Fonte: PAHO, 2023
Fonte: PAHO, 2023
The region's problem isn't only one of quantity. Some 600,000 doctors, nurses and midwives are missing against PAHO's 2030 target, but the aggregate figure hides the harder problem, which is where those professionals are. Training and employment cluster in the capitals and in the private network, and the distance between a central neighbourhood and the interior of the same country is usually greater than the distance between two countries.
The second obstacle is financial and it arrives before the appointment. Almost a third of total health spending is paid out of pocket by households, against a recommended ceiling of 20% (PAHO, 2023), while public spending fell to 3.7% of GDP — barely more than half the regional commitment of 6%. Out-of-pocket spending isn't a statistical abstraction: it's the patient who postpones the test, splits the treatment into parts, or disappears between the first appointment and the follow-up. In the practice it shows up as no-shows, drop-out and an unstable diary.
And the clock is running. People aged 60 and over made up 13.4% of the region in 2022, reach 16.5% in 2030 and 25.1% in 2050 (ECLAC). In under three decades the share of older people roughly doubles, with neither the geographic distribution nor the financing resolved.
2026–2030
Remote access stops being the exception
The first thing to move is the channel. Teleconsultation and formal second opinions come out of the regulatory-exception regime and become ordinary care, because they are the cheapest answer to a shortage that is one of distribution before it is one of numbers. The private network adopts first, having fewer layers of decision — which widens, in the short term, the access gap the region already carries.
2030–2036
The practice stops being an address
The structural change is the hybrid model becoming the standard rather than the improvisation: first appointment remote, tests in person, follow-up remote, continuous monitoring through data. The practice becomes one point in a chain of contacts, not the place where everything happens. For the doctor, the practical consequence is that being findable and understandable online comes to matter as much as the physical diary.
Where demand will be.
Each row rests on a figure from the grid above. These are areas of pressure, not revenue forecasts.
| Area | Why |
|---|---|
| Primary care and family medicine | It is where the shortage identified by PAHO concentrates, and the entry point that holds up the rest of the system. |
| Geriatrics and long-term care | People aged 60 and over go from 13.4% (2022) to 25.1% (2050), according to ECLAC — demand grows before the supply of specialists does. |
| Telemedicine and second opinions | It answers the region's real bottleneck, which is geographic distance rather than an absolute shortage of professionals. |
| Chronic disease and continuing follow-up | It is what suffers most from out-of-pocket spending: treatment stopped because of cost is clinical drop-out, not choice. |
What this means for the doctor
Here marketing serves access, not status.
Being found by someone three hundred kilometres from a referral centre isn't professional vanity — it is what decides whether that patient arrives at all. In a region where the barrier is distance and cost, a clear digital presence, published prices and a contact channel that actually answers are access interventions. The patient who understands what you treat, what it costs and how to reach you is the patient who doesn't postpone.
United States
The world's most expensive health system will keep running short of doctors — and the contest will be over positioning, not volume.
- 13,500 to 86,000
- projected shortage of doctors in 2036
- 187,130
- projected shortage in 2037 under a different official methodology — the same series gives 124,180 in 2027 and 167,030 in 2032
- 20,200 to 40,400
- shortage in primary care alone, in 2036
- 34.1%
- growth in the population aged 65 and over by 2036
Fonte: AAMC, March 2024
Fonte: HRSA
Fonte: AAMC, March 2024
Fonte: AAMC, March 2024
The United States spends more on health than any other country and still projects a shortage of doctors across the whole of the next decade. The problem isn't budget, it's distribution and composition: the two official projections disagree about the size of the gap, but agree that it exists and that primary care is the worst hit — 20,200 to 40,400 doctors on that front alone in 2036, according to the AAMC.
The workforce is ageing alongside the population it treats. One in five doctors in clinical practice is already 65 or older, and another 22% are between 55 and 64 (AAMC, 2024). Replacement isn't keeping pace, and the exit of that cohort is the main driver of the projected shortfall — not demand, which grows in parallel with the 34.1% rise in the population aged 65 and over by 2036.
What sets the American market apart is the mediation. The patient doesn't simply choose a doctor: they choose from a network their insurer has contracted. Add to that the consolidation of providers and the shift from volume-based pay to value-based care, and the result is a system where being good clinically and being chosen have become two separate problems.
2026–2030
Pay changes its criterion
The shift from volume-based payment to value-based care stops being a pilot and becomes a contract. In practice, what used to be rewarded — the number of procedures — starts being audited on outcome and total cost of care. At the same time, AI and healthtech are adopted faster than in Europe, with less regulatory friction, taking on administrative load first: documentation, coding, prior authorisation.
2030–2036
The shortage concentrates outside the big centres
HRSA projects that the shortage will be most severe in non-metropolitan areas and in primary care. Together with vertical consolidation among providers, that produces a two-tier market: integrated networks in the dense regions and care deserts outside them. For the independent doctor it is, at once, the sharpest competitive pressure and the widest window for differentiation of the decade.
Where demand will be.
Each row rests on a figure from the grid above. These are areas of pressure, not revenue forecasts.
| Area | Why |
|---|---|
| Primary care | 20,200 to 40,400 doctors short in 2036 according to the AAMC — the largest single gap in any breakdown. |
| Surgical specialties | 10,100 to 19,900 doctors short in 2036, from the same AAMC projection. |
| Geriatrics and care of older people | The population aged 65 and over grows 34.1% by 2036 (AAMC), and it is the band that consumes the most appointments and procedures. |
| Practice outside metropolitan areas | HRSA points to non-metropolitan regions as the worst affected — less competition, more unmet demand. |
What this means for the doctor
In a system where the patient chooses from within a network, digital reputation is commercial infrastructure.
When coverage defines the set of options, the final decision happens between doctors who are equally in-network — and it is made on whatever the patient can find out about each of them. A consistent profile, clear information about specialty and subspecialty, and presence where the searching happens stop being marketing and become a condition of operating. It isn't about showing up more: it's about being understood correctly by someone already allowed to come to you.
Europe
Europe won't lose quality. It will fight to keep its scale.
- 1.2 million
- doctors, nurses and midwives missing against the minimum needed to sustain universal coverage
- 20 countries
- in the EU reported a shortage of doctors across 2022 and 2023
- more than 1/3
- of EU doctors are 55 or older and due to retire within the decade
- 99 → 130 million
- people aged 65 and over in the EU, from 2025 to the projected peak in 2050
Fonte: OECD and European Commission, Health at a Glance: Europe 2024 (2022 figure)
Fonte: OECD and European Commission, Health at a Glance: Europe 2024
Fonte: OECD and European Commission, Health at a Glance: Europe 2024
Fonte: Eurostat, EUROPOP2025 projections
Europe enters the decade with universal coverage intact and under strain. Measured against the minimum staffing needed to sustain that coverage, 1.2 million doctors, nurses and midwives were missing in 2022, and twenty EU countries reported a shortage of doctors across 2022 and 2023 (OECD and European Commission, 2024). The system doesn't collapse: it lengthens the waiting list. And the waiting list is how Europe rations.
The ageing happens on both sides of the consulting room at once. More than a third of EU doctors are 55 or older and due to retire within the decade, while the population aged 65 and over goes from 99 million in 2025 to a projected peak of 130 million in 2050 (Eurostat, EUROPOP2025). More older patients, fewer available doctors, and replacement capped by how many the medical schools can train.
The short-term answer has been to import training: in 2023, more than 40% of doctors in Norway, Ireland and Switzerland had qualified outside the country where they practise (OECD and European Commission, 2024). That solves the local emergency and moves the problem to the source systems, which are generally weaker. For anyone practising in those markets, the figure matters for a different reason: the competition is international, and so the differentiation has to be.
2026–2030
The patient record crosses the border
The European Health Data Space starts to apply generally on 26 March 2027, with common specifications for interoperability, security and data quality in electronic health record systems. In practice, a patient's history stops dying inside each provider's software. One caveat: secondary use of that data only applies from 2029, and medical imaging and test results from 2031 — interoperability arrives in stages, not all at once.
2030–2036
AI arrives with more regulation and less speed
AI adoption in Europe happens under a thicker regulatory layer than in the United States, which means slower and more predictable entry. The stated direction is predictive, preventive, participatory, personalised and precise medicine — which only holds up on interoperable data, and that is why the data agenda comes before the AI agenda. For the doctor, the practical effect is that administrative work shrinks before clinical work does.
Where demand will be.
Each row rests on a figure from the grid above. These are areas of pressure, not revenue forecasts.
| Area | Why |
|---|---|
| General practice and primary care | It is where the shortage reported by twenty EU countries shows up first, and where the waiting list begins. |
| Geriatrics and long-term care | The population aged 65 and over grows from 99 to 130 million by 2050 (Eurostat, EUROPOP2025). |
| Specialties with structural waiting lists | Where the public system rations by waiting time, complementary private practice absorbs the backlog. |
| Private practice alongside the public system | Universal coverage does not mean immediate access — and the gap between the two is the market. |
What this means for the doctor
In a public system with waiting lists, differentiation happens in private practice and in specialty positioning.
Where everyone has coverage, nobody chooses a doctor for having coverage. The choice moves to whatever the patient can find out: what exactly you specialise in, what you treat most often, how soon they can be seen. Specialty positioning here isn't a marketing niche — it's the information that lets a patient decide whether it's worth waiting in the public queue or paying for the private appointment.
What runs through all four
Different systems, identical pressure.
More older patients, fewer doctors available, artificial intelligence absorbing administrative work, and the doctor's value shifting from performing procedures to interpreting, coordinating and deciding.
In any of the four scenarios, the professional who is found, understood and remembered will have predictability. What changes is the mechanism, not the conclusion.
Where we come in
PRIOS looks after the infrastructure of patient access.
Positioning, digital presence and patient acquisition within the medical advertising rules that apply where you practise, connected to how the practice runs. It isn't a loose campaign: it's a method, with metrics tracked closely.
See how we workFrequently asked questions
What the doctor asks.
Cost, timing and what separates a consultancy from an agency — answered straight.
How much does marketing for a practice cost?
The investment depends on the size of the practice and the scope of the work, both defined in the initial assessment. PRIOS works at fee levels set for mid-sized clinics and practices, outside the range charged to large networks. The initial assessment is free.
How long before it delivers results?
Organising your presence and your patient handling moves forward within the first few weeks. Gains in the diary depend on each practice's starting point and are tracked through metrics. We don't promise patient numbers — besides being unethical, medical advertising rules forbid it.
What's the difference between an ordinary agency and a healthcare-specialised consultancy?
An ordinary agency delivers campaigns and reach reports. A specialised consultancy knows the medical advertising rules, understands why a patient books and doesn't show up, and connects acquisition to how the practice runs. It's the difference between generating clicks and sustaining a diary.
In one sentence
- Physician density
- The number of doctors per thousand people in a region. In Brazil it goes from 2.98 in 2025 to a projected 5.25 in 2035.
- Care desert
- A region where the supply of doctors falls far below what the population needs. In Brazil it coexists with 58% of doctors concentrated in just 48 municipalities.
- Medical marketing
- The set of communication and patient acquisition strategies for practices and clinics, within the medical advertising rules in force in each country.
- No-show rate
- The percentage of patients who book an appointment and don't attend. It is one of the metrics a clinic's management tracks to protect the diary.
Free business assessment
Start with the assessment. The rest is your call.
PRIOS looks at your operation, points out where acquisition and the diary are losing patients, and shows where to start — at no cost and with no pushy proposal.
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