29 July 2012

The Looming Physician Shortage

Hardly news, but worth repeating:

The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.
In fairness, I've always felt these numbers are a bit inflated. Still, the shortage is quite real, and as the article makes clear, much worse in the less desirable areas of the country to live and work. Being in a trendy cosmopolitan area, I have no trouble recruiting. In fact, I tend to be swamped with applicants. However, I know of many rural ERs where they have to pay recruiters exorbitant sums to induce a board certified ER doc to come work there. There are also many more ERs where no certified ER docs will work (or too few, in any case) and they wind up making do with family practitioners or docs with more dubious backgrounds.


On an unrelated note, the job market for midlevel health care providers such as nurse practitioners and physician assistants is booming. 

8 comments:

  1. Sigh.

    Seems some fields are more easy to access then others. Geriatrics and Pediatric specialists are miserable long waits.. Our local children's hospital you can end up waiting for 6 months or longer for certain specialists. Family Drs. can only suggest you go sit in their ER to be seen sooner. Yet, if I need a podiatrist appt- I can get in tomorrow. Now if you need an orthopedic? That could take 2 weeks- hummm wonder how that bone will set in 2 weeks?

    IT is only going to get worse,right along with skyrocketing costs for those of us who pay our own way in life, and in a redhot hurry- that is unless you are a Senator,Congressman, Representative...etc.

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  2. Ok, so I'm from Canada, and we have the same problem here. From what I've been able to surmise, the only doctors we aren't short on are ER docs (most people here would disagree). We have way too few PCP's (and the ones we have are picky about the types of patients they'll accept-chronic illness types like me have no chance, because we have too many issues) and we have way to few specialists. I had an "urgent" appointment with a neurologist, which meant a 10 month wait (it got so bad, I spent 3 days in hospital before I saw a neurologist). I now have an appointment for a cardiologist, and I've been waiting 18 months already, and they still haven't phoned me with appointment time, which they will do about 3 months before the appointment. I most likely have POTS, and I would really like to know, so I can properly manage my symptoms. I've been tempted on many occasions to fly down to the MAYO clinic, just so I can get diagnosed.

    You say "looming," I say "current."

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  3. rural ER/Family physician7/31/2012 12:23 AM

    I wholeheartedly agree with your comments regarding the pending physician shortage, especially in the area of primary care and access to care as our population ages. I absolutely take offense to your comment of rural ER's making do with family practitioners or docs with more dubious backgrounds.
    Please guide me to the literature that proves board certified residency trained ER physicians have better outcomes than board certified Family Physicians in a rural ER setting.

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  4. While they ARE building more medical schools across the country, I haven't heard of them adding more residency spots. Which defeats the whole purpose.

    At Rural Doc:
    Does look specifically at urban vs. rural, but just at background in general.

    Malpractice occurrence in Emergency Medicine: Does residency training make a difference?

    The Journal of Emergency Medicine
    Volume 19, Issue 2 , Pages 99-105, August 2000

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  5. You can't blame people at all for not wanting to invest in a medical career.

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  6. Also there is the fact that the corporation is looking into how not to staff with MDs.

    It's about money honey.

    So, it will be a refusal to hire disguised as "there is a shortage of qualified candidates".

    -SCRN

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  7. rural ER/Family physician8/01/2012 8:01 AM

    At ER Jedi: so a retrospective review of malpractice claims, confounded by the fact that malpractice may or may not reflect the actual quality of care, is all you can come up with? So ER residency training prepares ER physicians to be better at covering their butts? Come on, any better literature than that?

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  8. I'm a recruiter in Connecticut, searching for an EM Physician for Presque Isle, ME. It's a lively town with an active medical community that inspired the TV Show Northern Exposure. Given the countless hours my team and I have invested in cold calls and mailings to practicing and resident physicians, advertising and exhibiting at regional and national industry events I would hardly call our fee exorbitant. But you are right that it's very difficult to find primary care doctors for rural communities.

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