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Tuesday, December 25, 2018

Ramifications of a Doctor Shortage

Although some people question the legitimacy of an upcoming doctor shortage, the AAMC (American Association of Medical Colleges) does not.  The AAMC predicts a shortage of up to 105,000 doctors over the next decade.  Those who do not believe there will be a shortage propose that with more efficient healthcare management, the projected shortage would be alleviated.  I will discuss that issue in my next blog.  For today, assume there will be a doctor shortage.  What would the ramifications of that be like?

In the AAMC study of projected doctor shortages over the next decade, there is a predicted shortage of primary care doctors of up to 31,000 doctors.(1)  Ironically, because of the push for more primary care doctors, the surgical and specialty care areas of Medicine will suffer even more.  Specialty care would include Neurology, Gerontology, Urology, Psychiatry, Opthamology, and medical subspecialties.  These are all specialties well utilized by seniors. By 2030, the number of people in the US greater than 65 years old will be growing by 41%, while those less than 18 years old will be growing by 5%. (1)  When seniors will be receiving 2-3 times more healthcare, they will need the specialty areas of Medicine more than ever!  These are the specialties facing some of the greatest shortages. (1)  It takes 5-10 years to train a doctor.  If we are not proactive about our future healthcare needs today, we will all “be dead” by the time the shortfall of doctors can be replaced to meet the deficit.

The AAMC projection graphs show multiple scenarios about the potential numbers of doctors practicing over the next decade.  The graphs show how the numbers will differ depending upon current doctors retiring at age 65, plus or minus 2 years.  Here is what I am seeing in my corner of the US.  Doctors are retiring before age 65.  The requirement for electronic medical records, coupled with the advent of managed care, is causing some doctors to just quit early.  About 6 years ago, a number of doctors sold their practices to hospitals or managed care companies.  After the initial “sweetheart” income deals evaporated and the new projected lower salaries were announced, the doctors just quit practicing Medicine. They had non-compete clauses and had lost control over their own practice of Medicine.  1/3 of the currently practicing physicians in the US will be greater than 65 years old over the next decade.  So this story could repeat itself quite a bit over the next decade.

Due to the thoughtless discard of unmatched fully qualified doctors, we are “shooting ourselves in the foot”.  Our population is ageing and their healthcare needs are escalating.  Just when seniors need medical specialties the most, there will be a shortage.  What are we thinking?  I guess we are not thinking, or the Residency Shortage would have been solved yesterday!