Is the Physician Shortage Easing?

The current physician shortage has implications in terms of a lack of medical care for a greater number of insured patients over the next few years, physician workload, and difficulties with recruitment.  There is, however, hope on the horizon.  Enrollment in family residency programs rose in 2011, rising 11 percent from 2010.  The University of California, San Francisco (UCSF), saw a 20 to 25 percent increase in medical applicants, according to Kaiser Health News. “Primary care has always had the strongest connection with public service and a public health agenda,” said Andy Bindman, professor of medicine at UCSF and chief of general medicine at San Francisco General Hospital.

According to Kaiser Health News’ Jenny Gold, “As the shortage of primary care doctors worsens in the U.S., experts are carefully tracking the interest of today’s medical students and residents in primary care, to see if a new generation of family doctors might be emerging.  By 2020, the Association of American Medical Colleges predicts that the country will be short 45,000 primary care physicians.  Some say the focus on primary care in the federal health overhaul law, called the Affordable Care Act, deserves much of the credit for rising interest in family medicine.”

Where will future doctors come from?  Today’s teenagers show little interest in healthcare and science careers, according to an online survey by Harris Interactive for University of Sciences. Forty-nine percent of 9th to 12th graders definitely or probably would not consider a career in healthcare or science, an 8.9 percent increase from the previous year.  Sixty percent of younger teens (age 13 – 15) also said they were not interested.  The survey found that those who were interested in pursuing healthcare- and science-based careers were primarily women and minorities.  Respondents interested in healthcare careers cited reasons, including financial motivations (“earning good money”), general interest, and public service (“want to help people”).  “It is essential that the sciences remain top of mind for America’s teenagers,” said Russell J. DiGate, Ph.D, provost at University of the Sciences.

The fact that states are slashing their budgets could force medical schools to cut back on admissions in 2012 is making a bad situation worse.  Texas medical schools are facing $500 million in combined cuts in the 2012-13 academic year, making them unable to fully fund students already enrolled, reports the Texas Tribune.  These schools are poised to see state payments for medical education fall by more than $12,000 per student per year, putting future admissions on the chopping block.

Some sources are not so certain that an end to the physician shortage is at hand.  Twenty-three percent of general internists and 40 percent of subspecialists are not renewing their internal medicine board certification,  according to research from the Journal of American Physicians and Surgeons. Older physicians especially will stop practicing than recertify, faced with extensive requirements and time commitments.  According a 2009 Association of American Physicians and Surgeons (AAPS) survey, just 30 percent reported that recertification improved their performance; just 22 percent would voluntarily do it again.

“This number will most likely increase as these processes become more expensive and more time-consuming, and continue not to reflect clinical practice,” Dr. Martin Dubravec said.  “Recertification has become a cottage industry of bureaucrats and testing agencies, dragging with them a few university physicians,” said AAPS President Lee Hieb.  “Accrediting bodies increasingly require continuous physician competency, and more boards require certification.  Hesitant physicians exiting practice could pose a significant problem that would leave a vacuum for physicians during times of shortage.”

“We cannot afford to drive our most seasoned, experienced physicians into early retirement,” said AAPS executive director Jane M. Orient, M.D. “They simply cannot be replaced.”

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