An Association of American Medical Colleges’ (AAMC) report first released in March 2015 warns that there will be approximately 1,000,000 less medical doctors in the U.S. by the mid-2020’s, one-third of which will be taken from the primary care sector.
The report’s projections are of particular concern given that 65 million Americans currently living in rural and poor urban areas are already isolated from a family doctor practice, according to Merritt Hawkins — a physician consulting firm.
In addition, the AAMC predicts that demand for physicians will increase by 17 percent over the next decade.
Specifically, the U.S. will sustain a primary care physician shortage between 12,500 and 31,100 by 2025.
“I think we really killed primary care in this country. It needs to be addressed yesterday.”
– Dr. Ramanathan Raju, CEO of New York public hospital operator NYC Health + Hospitals
Explanations for the lack of a significant new generation of family doctors point to four main areas: compensation, education, culture and life-expectancy.
Currently, the top paying medical sub-fields are in the “specialist” category. Cardiologists, dermatologists, radiologists and plastic surgeons, for example, earn approximately double the salary of family doctors and pediatricians, on average.
“From the patients standpoint, the most important doctor you have is the primary care doctor, who’s paid the least.”
– Dr. Richard Olds, CEO of St. George’s medical school
The Medical school system itself can also be blamed for the decline. Applicants are not screened for altruistic personality traits and the majority of the faculty is comprised of medical specialists, not primary doctors.
In addition, U.S. medical schools are heavily concentrated in the Boston to Washington, D.C., corridor and in the upper-Midwest, leaving large areas of the Great Plains and Northwest woefully under supplied with day-to-day medical professionals.
Lifestyle expectations have also changed for the millennial generation, according to medical head-hunter Phil Miller.
“We find that it takes more than one doctor coming out today to replace an old-style, baby boomer doctor”, says Miller. New doctors today want “nine to five” hours and would rather not be disturbed on weekends.
The fourth rail, as it were, to the upcoming doctor crisis is attributed to the lone positive development in this case: more Americans on the health insurance rolls as a result of the Affordable Care Act, combined with longer-life expectancy, means more demand for primary care services.
If the U.S. is to maintain the medical standards that were set in the second half of the twentieth century, double the current 25 percent of medical graduates will have to enter the primary care field.
Short of an altruistic health phenomenon, intervention by the federal government may be the only solution to this serious and complex problem.
In the mid-1990s, Congress passed a law to limit Medicare subsidies which helped fund medical residencies, as the perception grew that were would be an over-saturation of doctors in America by the early twenty-first century.
Since 2002, enrollment in U.S. medical schools has increased by 30 percent.
[MarketWatch] [Business Insider via Yahoo] [Photo courtesy cimedicalcenter.com]