Tuesday, April 20, 2010

US Faces Sever Shortage Of Doctors!


APRIL 12, 2010.
Medical Schools Can't Keep Up

As Ranks of Insured Expand, Nation Faces Shortage of 150,000 Doctors in 15 Years.


The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors.

Experts warn there won't be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.

That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.

The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient.

The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007.

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A shortage of primary-care and other physicians could mean more-limited access to health care and longer wait times for patients.

Proponents of the new health-care law say it does attempt to address the physician shortage. The law offers sweeteners to encourage more people to enter medical professions, and a 10% Medicare pay boost for primary-care doctors.

Meanwhile, a number of new medical schools have opened around the country recently. As of last October, four new medical schools enrolled a total of about 190 students, and 12 medical schools raised the enrollment of first-year students by a total of 150 slots, according to the AAMC. Some 18,000 students entered U.S. medical schools in the fall of 2009, the AAMC says.

But medical colleges and hospitals warn that these efforts will hit a big bottleneck: There is a shortage of medical resident positions. The residency is the minimum three-year period when medical-school graduates train in hospitals and clinics.

There are about 110,000 resident positions in the U.S., according to the AAMC. Teaching hospitals rely heavily on Medicare funding to pay for these slots. In 1997, Congress imposed a cap on funding for medical residencies, which hospitals say has increasingly hurt their ability to expand the number of positions.

Medicare pays $9.1 billion a year to teaching hospitals, which goes toward resident salaries and direct teaching costs, as well as the higher operating costs associated with teaching hospitals, which tend to see the sickest and most costly patients.

Doctors' groups and medical schools had hoped that the new health-care law, passed in March, would increase the number of funded residency slots, but such a provision didn't make it into the final bill.

"It will probably take 10 years to even make a dent into the number of doctors that we need out there," said Atul Grover, the AAMC's chief advocacy officer.

While doctors trained in other countries could theoretically help the primary-care shortage, they hit the same bottleneck with resident slots, because they must still complete a U.S. residency in order to get a license to practice medicine independently in the U.S. In the 2010 class of residents, some 13% of slots are filled by non-U.S. citizens who completed medical school outside the U.S.

One provision in the law attempts to address residencies. Since some residency slots go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these slots going to primary-care or general-surgery residencies. The slot redistribution, in effect, will create additional residencies, because previously unfilled positions will now be used, according to the Centers for Medicare and Medicaid Services.

From the ArchiveOpinion: How to Fix the Doctor Shortage (01/04/10)Health Blog: Would Adding Residency Slots Solve the Primary-Care Shortage? (11/27/09)Opinion: The Coming Shortage of Doctors (11/06/09)Health Blog: Obama: 'Severe Shortage' of Primary Care Doctors (08/11/09).
Some efforts by educators are focused on boosting the number of primary-care doctors. The University of Arkansas for Medical Sciences anticipates the state will need 350 more primary-care doctors in the next five years. So it raised its class size by 24 students last year, beyond the 150 previous annual admissions.

In addition, the university opened a satellite medical campus in Fayetteville to give six third-year students additional clinical-training opportunities, said Richard Wheeler, executive associate dean for academic affairs. The school asks students to commit to entering rural medicine, and the school has 73 people in the program.

Journal Communitydiscuss..“ As a specialist physician I will suggest that until primary care physicians can earn 70-80% of what most specialists make without killing themselves, there will be no incentive for the best and the brightest to go into primary care. ”
.—Michael Brennan.
"We've tried to make sure the attitude of students going into primary care has changed," said Dr. Wheeler. "To make sure primary care is a respected specialty to go into."

Montefiore Medical Center, the university hospital for Albert Einstein College of Medicine in New York, has 1,220 residency slots. Since the 1970s, Montefiore has encouraged residents to work a few days a week in community clinics in New York's Bronx borough, where about 64 Montefiore residents a year care for pregnant women, deliver children and provide vaccines. There has been a slight increase in the number of residents who ask to join the program, said Peter Selwyn, chairman of Montefiore's department of family and social medicine.

One is Justin Sanders, a 2007 graduate of the University of Vermont College of Medicine who is a second-year resident at Montefiore. In recent weeks, he has been caring for children he helped deliver. He said more doctors are needed in his area, but acknowledged that "primary-care residencies are not in the sexier end. A lot of these [specialty] fields are a lot sexier to students with high debt burdens."


Anonymous said...

Is this an impact of the health care reform? If this is one, then I can say that health care reform is not truly for the Americans but for few Americans only. Men in medical uniforms especially the doctors are quitting their jobs already and there is the latest news that nurses can be doctors if this shortage will really happen. Whew! Just like a domino effect that started from the government, to the doctors and will definitely end to the American people who will suffer the consequences of the shortage of doctors in the country.

B2 said...

This is definitely because of Obamacare. This is EXACTLY what I warned about before Obamacare was smuggled through. It's the first and most severe problem with National Healthcare and every country that has National Healthcare from Canada to the UK suffer with this problem. It's the main cause of the decline of quality in healthcare. Heck...Canadians currently have a 3-4 year wait for ... See Moresurgeries such as hip replacement! Doctors leave the country! The rewards of all the hard work to become a doctor don't pay off anymore so no one becomes new doctors anymore. Canada currently has 2,000 - 4,000 patients per doctor! And to prevent the national healthcare system from imploding, the Canadian gov't. took on the same strategy that Democrats are using to save (prolong the death of) social security. Lower Benefits and Raise taxes. First it was no PSA examinations, which is used to screen for prostate cancer in men, physiotherapy or chiropractic treatments, certain dermatological procedures, such as the removal of skin growths and eye examinations. Then an annual premium (spelled T-A-X), imposed on every taxpayer in the province.

It's coming United States...even though the polls clearly showed that Americans didn't want it and didn't ask for it...Obama gave it! Now we get to reap what HE sowed!