The Doctor Shortage
Merritt and Hawkins is one of the largest healthcare recruiting firm in the U.S. They published the results of a study that showed 48% of the physicians age 50-65 years of age are planning to cut back their office hours or retire within the next 1-3 years. The disturbing fact is that 1/3 of ALL physicians are in this age group.
To prepare for the physician shortage, new medical schools have opened and there is a small increases in the number of medical students in training. But there is a 8-12 year lag between training and practice and with the aging population it isn't hard to see what is around the corner. At a time when people want and need more medical care, there will be a serious shortage. Universal health coverage won't matter if there isn't anyone to take care of you. Having insurance and having access are not the same thing. Ask anyone on Medicaid or people who live in rural communities.
There is already a near crisis in California to find doctors to cover the Emergency Room. A wealthy community in Northern California cannot find a surgeon to be on call. Neurosurgery, ortho, ENT, opthalmology are all in short supply for ER call. Hospitals are paying large fees to doctors just to be available. It is traditionally younger, eager physicians who take ER call but there are no young, eager doctors in many places. According to this study we won't have any old tired ones either.
The largest decline in physicians is the primary care specialties (General Internal Medicine, Family Medicine, Pediatrics). I have written before about these specialties being grossly undervalued in our society. At the very least, it is time to recognize this and ensure that primary care specialties, with the the cognitive and coordinating value they bring, are reimbursed on par with procedural specialties. This is the only way young doctors will choose these specialties. THE ONLY WAY!
The unintended consequence of ignoring these facts will adversely affect our nations healthcare for decades to come.