Dr. Peter Stanos, PSA President
130,000 Doctors Needed by 2025
We already have a shortage of doctors in the United States and millions more Americans will soon have health insurance to cover trips to the doctor. What President Barack Obama’s health-care overhaul, the Affordable Care Act, doesn’t remedy is the dearth of residency openings.
While medical schools work to admit and train more doctors, the residency programs physicians MUST go through are at the same number that existed fifteen years ago. Here are some of the juicier excerpts from a Bloomberg article published this weekend:
The residency programs to train new doctors are largely paid for by the federal government, and the number of students accepted into such programs has been capped at the same level for 15 years. Medical schools are holding back on further expansion because the number of applicants for residencies already exceeds the available positions, according to the National Resident Matching Program, a 60-year-old Washington-based nonprofit that oversees the program.
The bottleneck will likely affect efforts at health-care reform, spreading doctor shortages that now largely affect rural communities to all parts of the country in the next decade. Patients will probably have to wait to see doctors if they can find room at all, undermining the prospect of cutting health costs through more preventative care.
“The training programs know that they are not now able to train the numbers of physicians that are going be needed,” said Tom Price, a Republican congressman from Georgia. “We need to be proactive on this as opposed to reactive. We’re actually already later than we should be in addressing the issue.”
The 2010 Affordable Care Act’s insurance expansion takes effect at a time when the U.S. has 15,230 fewer primary-care doctors than it needs, according to an Aug. 28 assessment by the Department of Health and Human Services. The Association of American Medical Colleges predicts the shortage, including specialists, will climb to 130,000 by 2025.
Of course, now is not the best time to be asking Washington to spend billions of dollars or to expect politicians to make tough decisions. Neither government funding nor private funding is near adequate.
“The problem is the structure of the program is no longer adequate,” said Price, who is also an orthopedic surgeon, in a telephone interview. “What we need I believe is fundamental reform of the funding stream.”
The influx of as many as 30 million new patients into medical offices starting in 16 months with the health-care law is igniting the debate over training doctors. Medicare now funds more than 75 percent of doctor residencies, a level capped by Congress in 1997.
In the U.S., medical students must undergo a residency at a teaching hospital of three to seven years, depending on their specialty, according to the American Medical Association. During this time, they train under the supervision of other doctors as a prerequisite to board testing that certifies them to practice on their own.
Many of these numbers and estimates were put together before the Affordable Care Act. As a matter of fact, when the residency cap was set, the American Medical Association was predicting a “surplus” of physicians.
The existing shortage is based on an ideal of roughly one primary-care physician for every 2,000 people, according to the health department’s Health Resources and Services Administration, which seeks to boost access to medical services.
Estimates of future shortages calculated before passage of the Affordable Care Act “obviously couldn’t be aware of all the changes that were put in play,” Ed Salsberg, who directs the health department’s National Center for Health Workforce Analysis, said in a phone interview. “There is a real need for new estimates that take more recent developments into account.”
When Congress capped Medicare-funded residencies, policy makers thought the U.S. had an excess of slots and wouldn’t need more doctors in the future because “everyone believed the health care system was going to change radically” with the advent of managed care, Grover said. That never happened.
PSA Partners agree with me that physicians and surgeons are going to be sought after, coveted, paid well and recruited hard for years to come. If you agree, request a PSA Partner Briefing and contact our office at 800-965-1620 to learn more.
Dr. Peter Stanos
