Green Room

The coming doctor shortage

posted at 12:46 pm on November 15, 2012 by

In which liberals learn how people respond to incentives. Who’d have thought highly trained professionals with $200K in school loans would gravitate toward higher paying specialized medicine slots instead of taking on general practice Medicaid patients for whom the government pays less and less in compensation?

The problem does not appear to be one of too few doctors in general; in fact, in 2011 a total of 17,364 new doctors emerged from the country’s medical schools, according to the Association of American Medical Colleges (AAMC). Too few of these doctors, however, choose primary care as a career — an issue that may be worsening.

In a 2008 census by the AAMC and the American Medical Association, researchers found that the number of medical graduates choosing a career in family medicine dropped from 5,746 in 2002 to 4,210 in 2007 — a drop of nearly 27 percent.

“It’s pretty tough to convince medical students to go into primary care,” said Dr. Lee Green, chair of Family Medicine at the University of Alberta, who was not involved with the study.

The pinch will get worse as Obamacare expands Medicaid’s patient load. There’s precedent for this— sigh, Romneycare:

Perhaps the best known example of this approach has been Massachusetts, which since 2006 has mandated that every resident obtain health insurance and those that are below the federal poverty level gain free access to health care. But although the state has the second-highest ratio of primary care physicians to population of any state, they are struggling with access to primary care physicians.

Dr. Randy Wexler of The John Glenn Institute of Public Service and Policy said he has concerns that this trend could be reflected nationwide.

“Who is going to care for these people?” he said. “We are going to have problems just like Massachusetts. [They] are struggling with access problems; it takes one year to get into a primary care physician. Coverage does not equal access.”

Experts offer solutions such as the federal government offering “incentives” on our dime to encourage more doctors into primary care, nurse practitioners taking up some of the slack, and my favorite, “hold[ing] political leaders accountable.”

“Looking at sheer reality, we can’t turn on a spigot and drop out new doctors,” he said. “Expect long waits if we cannot figure out how to resolve it, the only place left to go for primary care will be the emergency room.”

Green’s outlook was not as rosy.

“[Patients] won’t be able to see a primary care physician hardly,” he said. “Primary care will be past saturated with wait times longer and will not accept any new patients. There will be an increase in hospitalizations and increase in death rates for basic preventable things like hypertension that was not managed adequately.”

Meet the new two-tiered, government-distorted medical system, same as the old two-tiered, government-distorted medical system, only worse. Aren’t you glad we did this?

I know a few Georgetown Med School grads, and no one they know is going into general practice. They all know the economics and they know what’s coming.

Recently in the Green Room:

Blowback

Note from Hot Air management: This section is for comments from Hot Air's community of registered readers. Please don't assume that Hot Air management agrees with or otherwise endorses any particular comment just because we let it stand. A reminder: Anyone who fails to comply with our terms of use may lose their posting privilege.

Trackbacks/Pings

Trackback URL

Comments

I can not blame doctors one bit for this shortage. With the cost they have in becoming a doctor, getting more cost of a specialty, having an enormous liability cost(the lawyers suing for everything they do), and now having to deal with big bro, it will be a wonder if anyone wants to become a doctor?

In fact, I don’t know why anyone would want to become a nurse or nurse practitioners? Nurses have to have liability insurance also.
L

letget on November 15, 2012 at 12:59 PM

I know a few Georgetown Med School grads, and no one they know is going into general practice. They all know the economics and they know what’s coming.

Bet they all voted for OBozo.

Jaibones on November 15, 2012 at 1:03 PM

*beep* Thank you for calling Dr. ____’s office. We are no longer in business. If you are in labor and your contractions are closer than 5 minutes apart, call you congressional representative. Good day.*beep*

kurtzz3 on November 15, 2012 at 1:05 PM

Is there a Doctor in the house?

crickets.

portlandon on November 15, 2012 at 1:21 PM

Welcome to the reality we face here up in the socialist utopia of Ontario, with the wonderful government run health care system. Family doctors are in short supply. Huge swathes of the populace can’t find one, and it’s not getting any better.

Soon we won’t even have the option of going to the U.S. to pay for care, thanks to Obamacare crashing the system.

Isn’t equality wonderful! Everyone equally miserable and their health equally at risk.

Infantile socialists make me puke.

Blindsummit on November 15, 2012 at 1:21 PM

All the would-be doctors will now become lawyers, because God knows we don’t have enough of those … especially in an Obama-deconstructed world.

ShainS on November 15, 2012 at 1:28 PM

If you like your doctor, you can wait for your doctor.

forest on November 15, 2012 at 1:30 PM

My primary care physician retired just after ACA was passed. He saw the writing on the wall.

He explained, that as a primary care physician, a lot more patients would have to go thru him, before they could receive specialized care – his concerns boiled down to two issues: Cut-rate reimbursement from the Government, and not being able to provide his standard of care to the overwhelming number of new patients that he’d be seeing.

Hill60 on November 15, 2012 at 1:51 PM

I was in for outpatient surgery on Tuesday. The doctor doing the surgery had an Obama hat in his room when I was in for the consult before the surgery. While he was marking my head we talking a little, and he said he was so glad he was retiring soon because he didn’t like where he saw medicine going. I felt like saying something about his support for Obama and where HE saw medicine going but the doctor was going to be operating on my skull in the next few hours… and I don’t trust democrats to put their passions away for professionalism.

So, I am sitting here recovering with 12 stitches in my skull wondering if I should have said something – since this was after the election it would not have done any good. Was I prudent or a coward, I really don’t know?

talking_mouse on November 15, 2012 at 1:54 PM

that should be stitches in my scalp not skull. As a painkiller Oxycodone rock, but it does little for my ability to process.

talking_mouse on November 15, 2012 at 2:02 PM

There are no empty seats in medical school classes and waiting lists to get in. When specialties become saturated doctors will return to general practice – or begin new careers simonizing cars.

plewis on November 15, 2012 at 2:13 PM

There are no empty seats in medical school classes and waiting lists to get in. When specialties become saturated doctors will return to general practice – or begin new careers simonizing cars.

plewis on November 15, 2012 at 2:13 PM

What you will see — what you are already seeing — is in a seller’s market states will compete against each other to offer doctors the best economic conditions. That doesn’t just include the market itself, but also the state’s malpractice laws and any financial aid offered by the state to help doctors pay off their student loans (Texas already does this, paying off part of the loan in exchange for a four-year contract to work in low-income urban or rural areas. Many leave after the contract is up, but those areas do have health care service, albeit inexperienced. But it’s better than no physicians, which is what low-income and rural regions of states with weak malpractice suit protection laws and no financial compensatory deals are going to face in the near future).

jon1979 on November 15, 2012 at 2:37 PM

There are no empty seats in medical school classes and waiting lists to get in. When specialties become saturated doctors will return to general practice – or begin new careers simonizing cars.

plewis on November 15, 2012 at 2:13 PM

Maybe they can saturate a little my way then. As a family practice doctor there are several month long waits to get to see one of just 3 spinal orthopedic specialists in a three hour diameter. There is only a small handful of psychiatrists which means that I do the bulk of the prescriptions for psychiatric medication while my patients see psychologists (thank heavens there are a few of those) and the dermatologists have such a long waiting list that they don’t even take down names. The patients just call daily hoping there’s a cancellation.

I’ve never seen nor heard of medical specialists saturation. Or do you expect to see on Craigslist: Single White Radiologist, willing to put in long hours in the dark?

DrAllecon on November 15, 2012 at 2:45 PM

Well, the only solution will be the nationalizing of all Doctors. The Federal government will simple have to tell medical students what fields they are allowed to study in, and where they will be allowed to practice medicine. This will be the final solution to the impending shortage of doctors in the poorest neighborhoods. Forced government servitude at it’s worst.

At some point, history will see Obama as the President that returned SLAVERY to the United States!

Freddy on November 15, 2012 at 3:35 PM

Was I prudent or a coward, I really don’t know?

talking_mouse on November 15, 2012 at 1:54 PM

An Obama supporter with a scalpel? Prudent, I’d say, given the rabid hatred shown toward anyone who is NOT an Obama-worshipper by some of his followers. I wouldn’t take the chance of something being added to my body, or missing from it, or the general chance of shoddy workmanship, especially if he is retiring, making it harder to sue his practice for malpractice.

Now, telling him after the surgery is another story. As long as you are not going to be going to him for any procedures later.

Sterling Holobyte on November 15, 2012 at 3:42 PM

At some point, history will see Obama as the President that returned SLAVERY to the United States!

Freddy on November 15, 2012 at 3:35 PM

Well, that would be ironic, wouldn’t it?
All the people heralding his election(and re-election) as a turning point in race relations. Not realizing that he just turned it around to go backward.

Sterling Holobyte on November 15, 2012 at 3:45 PM

I got this e-mail today.. I get something similar about once a week.

A client of ours in Wisconsin has an URGENT need for General Surgery call coverage. 10 days a month plus one weekend per month. ASAP for 6 months. Must be board certified. Active WI license and DEA.

***Competitive pay package including: travel, lodging, and malpractice coverage***

Please get back to me ASAP if you or anybody you know will be interested in this locum opportunity.

There are no empty seats in medical school classes and waiting lists to get in. When specialties become saturated doctors will return to general practice – or begin new careers simonizing cars.

You have no understanding of my profession, the forces at work driving reimbursment, the time or effort it takes to train.

You have not a CLUE of the demand for my services.

As the physicians in the baby boom generation retire, there will be a paucity of general surgeons to deal with the demand. This is true with almost every specialty, except maybe pediatrics.

The current job I have went vacant for a year before I filled it. There a places practically BEGGING for help.

Green_Bay_Packers on November 15, 2012 at 3:48 PM