1. Dismiss Notice
  2. Download free Tapatalk for iPhone or Tapatalk for Android for your phone and follow the SDN forums with push notifications.
    Dismiss Notice

Physician Shortage

Discussion in 'General Residency Issues' started by Voxel, Sep 12, 2002.

  1. Voxel

    Moderator Emeritus 7+ Year Member

    Joined:
    Nov 5, 2001
    Messages:
    658
    Likes Received:
    2
    Anyone ever trend out the predictions for the number of people in Age 65+ category over the next decade? If one extrapolates this out to health care needs, (the demand) and given the constant number (roughly) of doctors completing PG training (supply), one can start to see what looks like a huge shortage. Good for physicians no doubt, but what about patient's ability to get elective medical care in a timely fashion? Will grandma have to wait 6-12 months for that hip replacement (like in canada and Great Britain)? With the supply and demand imbalance will medicare be able to sustain itself financially? Increasing the Medicare GME cap on the number of residency positions, raising taxes and increasing eligibility requirements (age/income) are but some solutions that no elected congress officials are willing to make.
     
  2. Note: SDN Members do not see this ad.

  3. Gradient Echo

    Gradient Echo Membership Revoked
    Removed

    Joined:
    Jul 12, 2002
    Messages:
    337
    Likes Received:
    1
    well, the government and general public isnt going to just sit back and live with a doctor shortage (if in fact that does happen) so I imagine the two most popular solutions will be:

    1) let PAs/NPs/other midlevel providers gain further autonomy and intrude further into the domain formerly reserved by MDs

    2) increase the number of FMGs coming into the US
     
  4. DocWagner

    DocWagner Senior Member
    7+ Year Member

    Joined:
    Aug 1, 2002
    Messages:
    520
    Likes Received:
    7
    Status:
    Attending Physician
    I am doubtful if the above poster's predictions will fully become truth, why? As patients age (65 +), they DON"T go to their FP doc. They have a tendency to call 911 and go to the ED. Or call their FP and he/she says "Go to the ED". Resulting in clogged ED hallways and tired EMS personnel. But also resulting in very wealthy cardiologists (mi's, r/o mi's) and radiologists (reading a zillion head ct's from mental status change).
    As the adult population ages, their illness seems to be more complex and the differential widens.
    Their really isn't any more autonomy a PA or NP can gain without becoming a huge legal risk regarding malpractice. They put themselves and patients at greater risk. True there are more PA's out there...but some shady programs have opened up overnight.

    Also, one must also notice that Osteopathic Medical schools have grown not only in class size, but have actually developed more programs in the past 10 years, while allopathic sizes have shrunk.
    (My class size was 230 students, and 3 new programs have opened in the past 6 years.)
     
  5. droliver

    Moderator Emeritus 10+ Year Member

    Joined:
    May 1, 2001
    Messages:
    1,556
    Likes Received:
    73
    Status:
    Attending Physician
    Ethan,

    you make excellent point re. the future patient population - these won't be young,healthy cohorts, but rather a group that will demand huge resources & specialty care in unprecedented #'s. I've never been very impressed with the ideas of AHP's (allied health providers) picking up some of the slack even I've seen it reported that they can safely handle > 90% of primary care office visits without requiring consultation with a physician.

    As far as the incr. # of osteopathic physicians, I have found it that (@ least on the group that resides here @ SDN) many have no interest in the traditional role for osteopathy for general medicine/family practice/primary care practices and aspire to just about every medical subspecialty except that (not that I blame them for that). Is that pretty typical while you were in school or do we just have a higher-achieving/aspiring group that tends to interact here? Really what I'm asking is whether this new group of physicians are clamoring to fill the niche that allopathic ones are avoiding?
     
  6. ckent

    ckent Membership Revoked
    Removed

    Joined:
    Jul 31, 2000
    Messages:
    2,138
    Likes Received:
    1
    There will never be a prolonged physician shortage as long as there are an infinite number of IMGs who would like to practice in this country. All it really takes is just opening up more residency spots, and almost all hospitals would like more residency spots because residents make good cheap labor. The same thing happened in the 50's-80's, there were not nearly enough medical schools to fill the ranks of physicians that this country needed so they just opened up more spots which were picked up by IMGs. There will always be more IMGs who want to practice in the US then actual residency spots. The advantage with physicians is that residency training can ideally standardize those who received their medical education abroad with US grads. One caribean grad was actually telling me how the IMGs we pick are actually often better then US grads because the people that US residency programs pick are at the top of their classes and IMGs have to work harder then US grads to get a residency spot. I could see that being the case sometimes, most IMGs are probably better then the bottom of the classes at the US schools because they have to be in order to get a spot. The real problem is the shortage of nurses. They are starting to go abroad to look for nurses now, but they will need a constant influx of nurses forever to keep up with the shortage unless this country's citizens change their attitudes about pursuing nursing as a career.
     
  7. Goofy

    Goofy Senior Member
    7+ Year Member

    Joined:
    Nov 20, 2001
    Messages:
    503
    Likes Received:
    2
    This comment lacks any type of insight to have real meaning. In point of fact there is not an 'infinite' number of IMGs waiting to enter this country. It may sometimes seem that way, and there are certainly more ready to start work than available slots, but I assure you that number is indeed finite, especially when you limit this to the more reputable foreign institutions.

    Another knee-jerk answer to a question that was never asked. This comment fails to fully appreciate how the residency system actually operates, but lets not facts get in the way of a perfectly good and mindless diatribe. Hospitals like residents because they are reimbursed immeasurably for ready source of slave labor. They will not simply 'increase' slots on a whim. These new potential employees need to be payed, and without government support, 'new slots' will never EVER appear.

    Further, even when and if the government starts to fund new residency slots, it will take an enormous amount of time to meet the current shortage. In case you were wondering, it takes many years beyond medical school to become a fully trained physician. Simply adding slots doesn't address the critical shortage we face TODAY. You can thank a subterfuge propogated by innacurate and deceiptful government funded studies for this. These 'studies' indicated a surplus, something that has never ever materialized. The government tried to dupe would be medical students into thinking there is some great shortage of PCPs when in reality, it was a location problem. There still remains an abundance of underserved areas in primary care. Finally, almost the entire country is underserved when it comes to surgical and specialty care.

    This comment reads like a government mantra of medical care. I bet you believe everything you read in newspapers too :confused:


    Another mindless assertion devoid of any real meaning. Comparisons of this sort are sabotaged by a lack of evidence. I would contend that even bottom of the barrel US grads are outstanding physicians. They recieve education that is unmatched on this planet, and given the sheer rigor of entering a US med school, they are certainly equipped with the scholastic acumen to succeed. IMG's while often bright and stellar, in many cases, attended schools with real issues regarding educational standards. Being able to perform well on the USMLE for example doesn't validate a good medical school education. It simply means you took kaplan course or the like. There are often real deficits in medical education that would never appear on a test of this nature. Some strides have been made with tools like the CSA exam, but there is clearly a big problem that remains.

    I'm not sure how some of these disjointed comments are to fit together, but you again have failed to see the big picture. Nursing resources have always been in flux. In fact several studies suggest that the shortages and surplus follow the economy. I'm not certain I agree with this completely, but to conclude we 'need a constant influx' intermanibly is somewhat purblind in my view. Clearly there is a shortage now, and it is detrimental to patient care. But to peg the blame squarely on a lack of nursing resources is shortsighted. We are clearly suffering from a critical physician shortage TODAY. With baby boomers and octagenarians the fastest segment of the population growing, it is likely to get much worse. Residency slots will not be able to keep pace with the shortage, as that is a solution that requires time. It may be a place to start, but it will be years before the benefits are fully appreciated.
     

Share This Page