LOL @ the AAMC

[fahimaz7]

How do they miss this? For decades they stated that that US was going to have surplus of physicians and now, even with the expansion that is set to occur, we are going to be at a huge deficit.

AAMC report predicts shortage of 124,000 physicians by 2025

A new AAMC report on physician supply and demand projects, if current workforce patterns stay the same, that the United States will experience a shortage of 124,000 full-time physicians by 2025. Changes in workforce and practice patterns could exacerbate this shortage; the report concludes, for example, that an increase in health care utilization rates and changes in physician work schedules could produce a shortage of more than 159,000 physicians, even with a moderate expansion of residency training and productivity improvements. U.S. medical schools are heeding the AAMC's 2006 recommendation to increase student enrollment. While these increases are a necessary step to ensure access to care, the new report concludes that they will not be sufficient to meet future patient needs and demand. In addition to increasing the supply of physicians, the AAMC report notes that health system changes-such as improving health care efficiency, reconfiguring health care delivery, and making better use of both physicians and other health care professionals-will also be necessary. "The Complexities of Physician Supply and Demand: Projections Through 2025" suggests that the national physician shortage is likely driven by such factors as U.S. population growth, aging population, aging doctors, and an increase in physician visits.


/discuss

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[armybound]

I thought everyone always knew that there was going to be a huge physician and nurse shortage?

They might have just been doing it to keep physician salaries and med school costs high. Who knows.

 

[chewsnuffles]

They might have just been doing it to keep physician salaries and med school costs high.

Ding Ding Ding! We have a winner!

Artificial scarcity is always a good thing if you like money.

However, there is also a far less nefarious cause here too. You can't very well "untrain" a physician and have them re-enter the work force in a different position. The switching costs are so high for the no longer needed physician that it is a disaster! In many ways, the AAMC not allowing "the market" to dictate supply and demand is a good thing. If it didn't exist, you would have swaths of un-employed doctors like you see with lawyers. The difference is, a J.D. is three years with no residency, and those skills can be applied in many other fields. With the unemployed doctor, re-paying medical school debt on the next best alternatives salery (a PA or NP) would be very, very hard, if not impossible.

 

[Emmet2301]

I heard that they will open up more medical colleges in order to combat the shortage. Also they'll probably start taking in more people from foreign countries.

 

[armybound]

Ding Ding Ding! We have a winner!

Artificial scarcity is always a good thing if you like money.

However, there is also a far less nefarious cause here too. You can't very well "untrain" a physician and have them re-enter the work force in a different position. The switching costs are so high for the no longer needed physician that it is a disaster! In many ways, the AAMC not allowing "the market" to dictate supply and demand is a good thing. If it didn't exist, you would have swaths of un-employed doctors like you see with lawyers. The difference is, a J.D. is three years with no residency, and those skills can be applied in many other fields. With the unemployed doctor, re-paying medical school debt on the next best alternatives salery (a PA or NP) would be very, very hard, if not impossible.

The government should start subsidizing the cost of medical school more.

I don't know why they expect physicians to work more hours for lower pay but also expect them to be perfectly capable of paying back that $250,000 in school debt without any assistance.

 

[sarahl86]

I always knew there is a nursing shortage, but with more options like DO/PA/NP that the number of physicians would be fine if not in excess...wow. Maybe all the schools I'm applying to this year will suddenly decide to increase enrollment by 30+ students and give out more acceptances so I've got a better shot

I would hope that more and more of us were going to be aware of the challenges we're going to have to endure because we are applying/studying to be doctors with the globalization and socialization of healthcare and a terrible economy...uggh.

 

[pazan]

Ding Ding Ding! We have a winner!

Artificial scarcity is always a good thing if you like money.

I'm usually more cynical about motivations, but I think in this case the shortage doesn't benefit physicians (otherwise they would be a hell of a lot happier as a group right now). In my opinion, there are two issues contributing to the shortage: moral hazard on the part of the patients (which wastes physician's time and health resources, making hospitals less likely to hire more physicians) and moral hazard on the part of the physicians (like ordering tests with high reimbursement rates or to prevent malpractice, which does exactly the same thing). Changing how patients access specialists and how physicians are reimbursed will make the health care system more efficient, and is probably a better solution than pumping out 100,000 more doctors who will increase the bureaucratic mess. I have no idea how they'll make the system more efficient and improve patient satisfaction at the same time... managed care didn't work and socialized medicine isn't the answer either (just ask people in England/Canada).

Anyway, we do need more physicians, but we also need more efficient physicians.

 

[armybound]

I think physicians are efficient, it's the legal/financial pressures placed on the system that make it inefficient.

 

[fahimaz7]

I always knew there is a nursing shortage, but with more options like DO/PA/NP that the number of physicians would be fine if not in excess...wow. Maybe all the schools I'm applying to this year will suddenly decide to increase enrollment by 30+ students and give out more acceptances so I've got a better shot

I would hope that more and more of us were going to be aware of the challenges we're going to have to endure because we are applying/studying to be doctors with the globalization and socialization of healthcare and a terrible economy...uggh.

I wish it was that easy! The school that I'm headed to is in the process of going from 190 students to 240 students (in the next few years). The LCME accreditation committee requires a full look at the program to increase attendance by even one new student and prove that they have the classroom space, clerkship space, etc to take on any additional students.

Medical education is a slow process and I'm shocked to see that in 15 years we're going to have a shortage of that magnitude. MD programs put out... what... 30k students/year? That's 5 years worth of students...

 

[dragonfly99]

pazan has a point, actually.

Med schools are increasing their number of 1st year positions, and that does/will benefit you (applicants).

 

[chessknt]

Ah, if only physicians could actually gain some clout by using a shortage to their advantage. I am all for quality patient care, but anything we can do to improve our horrible position in medical bureaucracy is welcome, even if it takes a decrease in care to get the attention of lawmakers.

 

[armybound]

I wish it was that easy! The school that I'm headed to is in the process of going from 190 students to 240 students (in the next few years). The LCME accreditation committee requires a full look at the program to increase attendance by even one new student and prove that they have the classroom space, clerkship space, etc to take on any additional students.

Medical education is a slow process and I'm shocked to see that in 15 years we're going to have a shortage of that magnitude. MD programs put out... what... 30k students/year? That's 5 years worth of students...

whoa, I think med schools put out way less than 30k physicians/year.

it's less than 20k

 

[aebvd97]

Medical education is a slow process and I'm shocked to see that in 15 years we're going to have a shortage of that magnitude. MD programs put out... what... 30k students/year? That's 5 years worth of students...

Not to be picky, but MD programs put out about 18,000 a year...far short of 30k.

 

[fahimaz7]

Not to be picky, but MD programs put out about 18,000 a year...far short of 30k.

Maybe it's MD+DO~30k/year? Either way, that's a horrible deficit to be facing even with the increased enrollment numbers and residency positions.

 

[phospho]

Not to be picky, but MD programs put out about 18,000 a year...far short of 30k.

you are correct,

for 2008, 42,231 applied, and 18,036 matriculated

http://www.aamc.org/data/facts/2008/2006to2008det.htm

http://www.aamc.org/data/facts/2008/2006to2008detmat.htm

theoretically, 96% of the matriculants actually graduate

http://www.aamc.org/data/facts/charts1982to2007.pdf

I don't know anything about DO's though

 

[fahimaz7]

In 2004,

15099 (64% of residencies) were filled with allopathic graduates

2,756 (11% " ") were filled with osteopathic graduates

6,013 (25% " ") were filled with international graduates (Non-US)

Total filled: 24,012 residency spots.

www.aamc.org

 

[BTC]

Given that physicians are some of the most highly skilled and trained professionals around, I am at a loss as to why they have not organized and gone against insurance companies and medicare when their reimbursements do not cover the cost of treatment.

 

[phospho]

Given that physicians are some of the most highly skilled and trained professionals around, I am at a loss as to why they have not organized and gone against insurance companies and medicare when their reimbursements do not cover the cost of treatment.

i would definitely take a look at this thread...well worth your time...

http://forums.studentdoctor.net/showthread.php?t=485968

 

[Bacchus]

I don't want to say this a relief, but it is. It was speculated last year and the year before we'd be facing a shortage of 200,000 physicians. Glad to see that is lessened by 75,000.

 

[beachblonde]

Given that physicians are some of the most highly skilled and trained professionals around, I am at a loss as to why they have not organized and gone against insurance companies and medicare when their reimbursements do not cover the cost of treatment.

In a way, they have tried.

Simplified in the extreme: way back in the day when HMOs were emerging (post WWII), the AMA prohibited its members from joining them. The physicians who wanted to be part of managed care and still AMA members sued them. Turns out the AMA lost, as anti-trust laws apply to them, and by prohibiting members from joining HMOs they were violiting some such anti-trust terms (I'm not a lawyer...clearly). Hell, they even lost a lawsuit to a bunch of chiropractors when they said that chiropractors weren't true clinicians.

I'm inclined to say the AMA is more interested in keeping its nose clean than going up against the insurance companies.

 

[cbrons]

I thought everyone always knew that there was going to be a huge physician and nurse shortage?

They might have just been doing it to keep physician salaries and med school costs high. Who knows.

Come on dude... you are seriously cynical. Why would the caring lobby ever do such an evil thing, just for more money?

You win the prize... pick one (but just one):

 

[pazan]

Given that physicians are some of the most highly skilled and trained professionals around, I am at a loss as to why they have not organized and gone against insurance companies and medicare when their reimbursements do not cover the cost of treatment.

It seems like it should be that easy, but it definitely isn't. Some physicians don't accept medicare or certain kinds of insurance, which contributes to health disparities and doesn't make a dent in medicare's unilateral control of reimbursement rates. Hospitals have to comply with EMTALA and cut costs (which means cutting physicians sometimes). Also, if doctors collectively strike against insurance companies, the patients are the ones who suffer. I think providers, as a group, have much less power than insurance companies and hospitals. We're going to be the ones with the real obligation to treat patients, which means we have the least amount of leverage and leeway.

 

[flip26]

I think (somebody else can research it) that the Hillary Care Task Force in the early 1990s forecasted a surplus of physicians - I assume other groups did the same - but it has only been in the last decade that the reality is we face severe shortages, particularly in primary care.

It is my understanding that plans to increase the number of med schools, etc, in the 80s and 90s got shelved as a result of these forecasts, and we (society) are paying that price now because it takes at least 10 years to plan, build, and bring online a new medical school, and this problem is not going to be solved quickly...

Also the burnout rate for physicians has increased dramatically (stress, dissatisfaction with medical practice, govt red tape, decreasing compensation) and doctors are retiring younger, or quitting practices, at younger ages and at rates much higher than previously forecasted, making the shortages worse.

 

[TMP-SMX]

The problem with building medical schools is that down the line there just aren't enough residents and attendings to teach them during rotations. The situation is bleak in Michigan. MSU's DO students are moving en masse to the DMC and to Saginaw Synergy. So while WSU still has a lot of spots at the DMC, MSU is going to have to compete at Synergy because one of the Caribbean schools is giving an insane amount of money for them to take them in. The problem is, of course, not in IM/FP. The problem is in the required rotations that there just aren't enough manpower.

 

[154465]

The problem with building medical schools is that down the line there just aren't enough residents and attendings to teach them during rotations. The situation is bleak in Michigan. MSU's DO students are moving en masse to the DMC and to Saginaw Synergy. So while WSU still has a lot of spots at the DMC, MSU is going to have to compete at Synergy because one of the Caribbean schools is giving an insane amount of money for them to take them in. The problem is, of course, not in IM/FP. The problem is in the required rotations that there just aren't enough manpower.

Yeah things are looking scary for us. Recently the Caribbean schools offered our hospitals millions to let their med students train. They were turned down because they are currently tied up in contracts with us, but who knows whats gonna happen down the road. You can be damn sure the Carib schools aren't gonna just stop trying...

 

[chessknt]

It seems like it should be that easy, but it definitely isn't. Some physicians don't accept medicare or certain kinds of insurance, which contributes to health disparities and doesn't make a dent in medicare's unilateral control of reimbursement rates. Hospitals have to comply with EMTALA and cut costs (which means cutting physicians sometimes). Also, if doctors collectively strike against insurance companies, the patients are the ones who suffer. I think providers, as a group, have much less power than insurance companies and hospitals. We're going to be the ones with the real obligation to treat patients, which means we have the least amount of leverage and leeway.

Not if we, as a group, refuse to sell ourselves at discount prices and inform patients that if they want care they need to write their insurance companies and ask them to make their compensation equivalent to the quality they desire. We sell our labor, we should be able to control at what price we sell it for to some degree.

 

[atomi]

They might have just been doing it to keep physician salaries and med school costs high. Who knows.

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

 

[TMP-SMX]

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

None of your posts make any sense. If the AMA had any power, physicians wouldn't have to work so many extra hours just to have their income remain the same. PCPs would have better Medicare reimbursements, and insurance reimbursements would follow. However, that just isn't the way it is.

 

[chessknt]

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

Exorbitant salaries? Take a look at some of the Wallstreet CEOs and sports team players before you make that claim.

And insurance is a cartel that makes a profit off of the sick without actually doing anything to help them, at least doctors get their hands dirty.

 

[niranjan162]

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

I remember reading that drs salaries form 15-17% of total healthcare costs. The other 80 something % is caused by politicians lawyers etc.

 

[phospho]

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

dude, are you serious? i hope you were kidding...

 

[Bacchus]

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

You may want to work for less salary, but 95% of this board sure as hell doesn't. .

Unless you're going to a rediculously cheap state school money is an issue.

 

[87138]

Correct response. This has been going on for nearly 100 years. At the expense of public health. Where do doctor's exorbitant salaries come from? Who pays for all that? The public, of course. Creating a cartel to guarantee huge payouts from at the expense of the sick is, well, just sickening.

Hopefully Obama will put an end to it.

Didn't you hear? Obama is going to pay off all our individual debts. And pay for our gas or bus fare.


YES HE CAN!

 

[DrYoda]

Didn't you hear? Obama is going to pay off all our individual debts. And pay for our gas or bus fare.


YES HE CAN!