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Doctor Deficit Will Devastate US Health Care

A disaster looms for U.S. health care: WaPo reports that an alarming number of doctors say they are fed-up, stressed out, overworked, and micro-managed in their primary care practices. The result? By 2020 the U.S. medical system will have 45,000 fewer primary-care doctors than we need, according to the Association of American Medical Colleges. Some doctors are retiring altogether, while others are taking jobs at hospitals:

A 2012 Urban Institute study of 500 primary-care doctors found that 30 percent of those aged 35 to 49 planned to leave their practices within five years. The rate jumped to 52 percent for those over 50. […]

RAND study for the American Medical Association last year found that nearly half of surveyed physicians called their jobs “extremely stressful” and more than a quarter said they were either “burning out,” experiencing burnout symptoms “that won’t go away” or “completely burned out” and wondering if they “can go on.”

Some of these doctors will land in hospitals and thus remain in the medical system, but consumers will still be worse off. For one thing, hospitals charge more per procedure than other care providers. In addition, as they gain more doctors, hospitals will acquire more market power, thus making it even harder than it already is for insurance companies to negotiate cheaper prices for their customers.

The doctor shortage is one of those seemingly small, pesky details Obamacare largely ignored (or even made worse). But it is becoming the next big challenge for serious reformers.

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  • Boritz

    Primary care physicians went to college 8+ years to land a job that while traditionally well compensated also involves a lot of looking into orifices. Let’s attack any job satisfaction pluses by piling on red tape to the point where no smart or even sane person will put up with it.

    • Andrew Allison

      We could solve the problem at a stroke by eliminating the insurance overhead [/grin]

  • Andrew Allison

    Consider the sources: the Association of American Medical Colleges and the AMA. The feed has several times reported on the rise of alternatives to MD primary care (nurse practitioners, in-store clinics, etc.), all of which are being fought tooth-and-nail by these very bodies. Rather than declaring that a disaster looms for US healthcare, perhaps some consideration of the potential decline in demand for primary care physicians might be in order?

  • Fat_Man

    Obama grabbed the healthcare problem in the US by the wrong end. His diagnosis was that the problem was lack of demand caused by too many people lacking insurance or having “sub-standard” insurance. In doing this he was supported by the hospitals and doctors who wanted more money and no controls.

    In fact the problem is insufficient supply to meet a demand that is hyped by too many dollars supplied by third parties with no control over how they are spent.

    Real solutions would include busting hospital monopolies, creating price transparency, adding lots more professionals.

    The US has a very low number of doctors for its population (about 2/3 of other OECD countries). We need more medical schools and shorter cheaper training programs. Requiring a BA before medical school is a waste. A pre-med only needs 10 out of 32 semester courses in a BA program. That means more than 2 years is wasted on irrelevant course work. A program that covers the pre-med courses and the first 2 years of medical school would be faster and cheaper. The med schools could then concentrate on hands on training.

    • Maynerd

      The biggest financial problem with our health care system is that most patients don’t pay for their health care. Since the cost of health care is heavily subsidized by third party payers, the demand for health care is infinite.

      We spend insane amounts of dollars on end stage disease. Individuals and famiies would be more prudent in their expenditure if they bore at least a portion of the cost. Live transplants and renal dialysis are not constitutional rights.

      The system is not sustainable and its unraveling will be ugly.

  • free_agent

    It sounds like one of those periodic shortages of particular classes of workers that comes about when a limited number of “employers” (in this case, insurance companies) can drive wages below the point where potential new workers consider the investment of learning the trade to be worthwhile. The number of workers drifts down until the shortage of workers triggers a bidding war. Wages rise to the point that people enter the trade again and the shortage abates. Then the semi-cartel starts driving wages down…

    I’ve read that this happens periodically in the nursing profession (where the employers are hospitals).

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