For years, the medical community has tried to raise awareness of the doctor shortage in the United States. And for years, few people seem to have heard the call.
There are many factors contributing to this shortage. In this post, we look what caused this shortfall as well as possible solutions.
How Many Doctors Does America Need?
The American Academy of Family Physicians (AAFP) recommends at least one primary care provider (PCP) for every 2,000 people. This is the number proven to improve patient care, lower healthcare costs, reduce ER visits, and lower mortality rates.
As of 2013, we were short by around 6,640 physicians. Of course, that number only accounts for PCPs. Specialty shortages are much greater – two to three times greater, as a matter of fact. What’s more, the gap has widened more quickly than even the experts expected.
Expected shortages by 2030 include:
- Primary care physicians: 14,800 to 49,300
- Surgical specialties: 20,700 to 30,500
- Other specialties: 13,100 to 42,200
The Association of American Medical Colleges (AAMC) expects the United States doctor shortage to possibly top 120,000 physicians by 2032.
Why Is There a Doctor Shortage in America?
Simply put, the demand for doctors is greater than the supply. A number of factors contribute to this dynamic. We look at what are probably the five biggest contributors below.
1. An aging population
Americans are living longer than ever before, which is great. Unfortunately, it’s no surprise that, as they age, these Americans also require more healthcare due to chronic conditions like diabetes and heart disease.
2. A healthier population
One of the reasons Americans are living longer is that they’re taking better care of their health. We’re losing weight, quitting smoking, eating healthier, and exercising more. While the AAMC expects this to have a short-term beneficial effect, they expect the increased longevity to result in a need for 17,300 more doctors.
3. The doctors themselves
It isn’t just the population in general that’s getting older. According to the AAMC, more than one-third of currently active physicians will turn 65 within the next 10 years.
Doctors today are also embracing the idea of work-life balance, meaning they’re working fewer hours each week. Somewhat surprisingly, this trend crosses all age groups. If it continues, AAMC expects it to be the equivalent of losing 32,500 FTE physicians.
4. Stagnant government funding
We’re all familiar with the government’s fight over healthcare funding. What most people fail to recognize, though, is that this goes beyond the debate over government-funded programs like Medicare.
Specifically, government funding supports graduate medical education (GME). This is the residence training new doctors receive. Government funding for GME has not changed since the Balanced Budget Act of 1997. That’s 22 years of stagnant funding. To understand how that looks in real life, prices in 2019 are 58.38 percent higher than they were in 1997.
This lack of funding has created shortages in certain specialties, impeded training opportunities in rural areas, and makes it impossible for training to keep pace with improvements in healthcare.
5. Lack of physicians in private practice
Doctors who work in private practice instead of a hospital setting see more patients. According to the American Medical Association, though, less than half of doctors worked in private practice in 2016. Doctors in private practice are also less likely to burn out early, meaning they continue practicing medicine longer.
Unfortunately, more doctors choose to work in a hospital setting because there is so much risk in opening a private practice. Much of this has to do with administrative hassles, particularly the hoops insurers expect doctors to jump through. An additional burden is the fact that opening your own practice is essentially choosing to run a business. And, while medical school is great at teaching doctors about medicine, it doesn’t include training on how to run a business.
Can We Solve the Doctor Shortage?
There are ways to address the doctor shortage. Let’s start with the fact that so many doctors choose to work in a hospital setting instead of opening their own practice.
According to Dr. Miriam A. Knoll, the key to correcting this imbalance is reducing physicians’ administrative burden. In that linked article, Dr. Knoll describes common scenarios of dealing with insurance companies that place an enormous time burden on physicians. Those hours are not only unpaid, they cut into the time available for treating patients.
Expanding use of technology is another possibility. Telemedicine, also known as digital healthcare, continues to grow rapidly. It is especially hopeful for those living in rural areas, where the doctor shortage is felt more keenly. Shortages here mean that patients often wait months for an appointment and drive an hour – and often more – to see a doctor.
Another recommendation is to expand the care team to include physician’s assistants and nurse practitioners. They’re training takes only two or three years while a PCP’s training lasts almost eight years.
Increase GME Funding
The Association of American Medical Colleges is working to raise awareness of how the lack of funding directly impacts Americans’ health and wellness. The group encourages everyone to get involved and talk to their congressperson. Their site offer an easy-to-understand explanation of what’s happening and why it matters. Of course, if you’ve ever had difficulty getting in to see a doctor, you already know.
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