Increasing Shortage of U.S. Doctors

Medicine has long been the career of choice for the nation's best and brightest, but recent reports suggest that clinical practice is rapidly losing its appeal.  In a 2012 survey by Medscape, only 54%  of physicians would opt to practice medicine again, which is a significant drop from 69% only a year earlier. Due to loss of control over their professional responsibilities, consolidation of healthcare organizations and diminished income, more physicians are regretting their decision to join the medical profession.  This widespread dissatisfaction has serious implications for future generations who may choose more lucrative and less burdensome occupations.

The current state of medical care in the United States is, of course, considerably better than most countries, but is not optimal.  The U.S. currently ranks 20

th

in doctors per 100,000 people. According to the Kaiser Family Foundation, there were approximately 812,000 practicing physicians in the U.S. with almost 425,000 primary care practitioners. Many of these physicians, however, are congregated in the most lucrative states. Massachusetts boasts the highest physician/patient ratio in the nation with 314.8 per 100,000; this state, which has had almost universal health coverage since 2006, is also one of the healthiest in the nation. On the other hand, Mississippi has the lowest ratio with 159.4 physicians per 100,000 residents and has the lowest life expectancy in the nation. (USA Today)

While the Affordable Care Act may help these lower income states by producing more insured patients, there is still a growing gap between the number of patients and available caregivers.  The Association of American Medical Colleges projects that there will be a shortage of almost 90,000 physicians by 2020. This growing treatment gap will also widen as more Americans sign up for health care insurance under the Affordable Care Act, adding millions more to the case loads of primary care and specialty physicians. These patients are also likely to require more medical care as the Baby Boomers age and the U.S. population as a whole grows older.  This is also exacerbated by the number of physicians who will retire in the coming years; almost 40% of physicians are 55 years or older.

Forbes contributor Dr. Robert Pearl also cites the continuing inefficiencies of the American health care system which inhibit efficient delivery of patient care, may seem logical to begin training some 90,000 new physicians…but we need to make our system 10 to 20 percent more efficient.  Once we do that, we will have enough physicians." These systemic issues include lack of primary care doctors, diminished assistance from support professionals, unnecessary testing and procedures, and resistance to patient care technology.

There are also organizational issues that are dissuading promising candidates from choosing a career in medicine.  The first is the burgeoning administrative responsibilities related to practicing.  More patients are utilizing two or more payment services like Medicare and private insurance which produces more paperwork.  In a study found in the International Journal of Health Services, it was found that the typical doctor spends 8.7 hours per week on administrative duties.

Not only does this limit the time spent treating patients, but it dulls the enthusiasm many physicians have for clinical practice.  This disillusionment is also heightened by the high volume environment that a growing number of physicians practice.  More private practices are being consolidated into large Accountable Care Organizations, which tend to emphasize efficiency over quality of care.

There is some good news for medical professionals, however.  The AAMC reports that there are currently 18 new medical schools in the planning stage, with many of these programs reportedly focusing on primary care practitioner preparation.  This is complemented by many existing medical education programs that are expanding their rosters. 

There is little doubt that practicing medicine is rapidly evolving in America.  Whether the profession's immense challenges will eventually stifle the influx of young doctors, or the industry will develop solutions is unclear, but people will always require medical care; it merely remains to be seen how doctors will offer these essential services in the future.  

Article written by:

Robert Moghim, M.D.

CEO, Health Carousel Locum Tenens