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Tuesday, February 27, 2018

Residency Shortage = Doctor Shortage

Many people cannot relate to the current situation with the residency shortage.  My local congressman asked why the unmatched doctors could not just go and apply elsewhere for a job.  The rigid system in place for educating a doctor is very unforgiving.  Without a US residency, a doctor cannot obtain a medical license in the US, period.  One thing we can all relate to however, is the results of a doctor shortage.  That is when it will really mean something to which everyone can relate.

Updating a previous blog about the “Ramifications of a Doctor Shortage”, I wanted to talk more specifically about what this doctor shortage could entail.  The AAMC (Association of American Medical Colleges) now predicts that, “By 2030 the US population under age 18 is projected to grow by only 5%, while the population aged 65 and over is projected to grow by 55%.  Because seniors have a much higher per capita consumption of health care, the demand for physicians- especially specialty physicians- is projected to increase.”(1)  Additionally, on a scale of 1-5, the US currently has a per capita number of doctors of 2.6 compared to Austria at 5.0 (2)  Sweden, Switzerland, and Germany all have about 4 doctors per capita (2).  The US even falls behind the number of doctors per capita of a 3.4 average for other developed countries.  So the US already lags behind per capita in current number of physicians, and this scenario is predicted to get even worse up to the year 2030.  The US is predicted to have a 105,000 doctor shortage. 

Let’s talk about one of the most critical areas of the projected shortage.  “A shortfall of between 33,500 and 61,800 non-primary care physicians is projected by the AAMC (includes surgical and other specialists).”  Think about the average person’s use of doctors.  For females between 0-21, we would assume girls initially go to a primary care doctor and then change to an OB-GYN doctor in the teen years.  Perhaps they would go to the doctor once/year, and sometimes even less.  As I watched my own Mother as she aged she utilized the following physicians:  Primary Care, OB-GYN, orthopedist, Otolaryngologist, Cardiologist, Dermatologist, Audiologist, Ophthalmologist, Gastroenterologist, and Pulmonologist.  I am counting at least 10 specialists, and some on a frequent basis each year.  Going to a doctor has become part of the weekly ritual for many seniors.  Just imagine the difficulty that will be forthcoming in the next decade in receiving quality care from medical specialists.  Personally, I have called the office of a gastroenterologist each day for 3 days, have never talked to a human, left messages, and still have not received a call back.  The office message says to expect delays due to the high volume of calls (and I live in a city, not a rural area). 

 Now back to the current travesty of the residency shortage.  We can see how the non-medical person can relate to the upcoming doctor shortage.  But this doctor shortage directly correlates with the current medical residency shortage.  We as a Nation have been “discarding” fully educated and qualified doctors at the rate of 10,000 unmatched doctors per year.  The AAMC keeps writing about the need to increase the number of residency slots to prevent the loss of thousands of doctors, but to no avail.  No “one” person seems to be taking this impending crisis seriously.  It takes a minimum of 7, and up to 10 or more years, to educate and train a doctor, especially a surgeon or medical specialist.  By the time the doctor shortage is fully realized, the “solution” will take that amount of time and more to catch up with the deficit.  We need to act now to correct the residency shortage to prevent an impending doctor shortage in the future!