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How to Ease the Coming Physician Shortage
Michigan Capitol Confidential ^ | 4/10/2016 | Kahryn Riley

Posted on 04/13/2016 5:55:29 AM PDT by MichCapCon

The U.S. will face a shortage of 46,000 to 90,000 physicians by 2025, according to a report issued by the Association of American Medical Colleges. Meanwhile, the U.S. Department of Health and Human Services notes that the population of Americans age 65 and older will double between 2013 and 2040, swelling to 98 million. Older patients face complex health issues that require more frequent and intensive forms of treatment.

These trends suggest that if nothing is done to lower the high barriers to people seeking medical careers, it will only be a few years until patients will not be able to find the treatment they need.

The cartels that dominate medical professions make it extraordinarily difficult for individuals to enter the field. According to the American Medical Association, most doctors require 11 to 15 years of education and training before they are eligible for a state license to practice. This timespan includes four years of undergraduate study, four years of medical school, and, depending on the specialty, three to seven years of residency. Would-be physicians must then pass a series of exams before they obtain a license.

This process leaves the average new doctor with $169,601 in debt, plus roughly a decade in foregone earnings. And it’s not just the new docs who pick up the tab for their training: U.S taxpayers contribute around $15 billion each year to educating new doctors.

Aside from the extraordinary financial cost and time required for medical training, another factor in the upcoming shortage is a cap on the number of residency slots. A medical residency is something like an apprenticeship, with new doctors prohibited from going into independent practice until they have served several years under the supervision of an already-licensed physician. While more medical schools have opened in recent years to meet the growing demand, there has not been a corresponding rise in residency positions.

Taxpayers pay for most residency positions through their Medicare and Medicaid dollars, but in 1997, Congress froze the number it funds at 100,000. The Association of American Medical Colleges has lobbied Congress to fund 15,000 more residencies, but in 2014, President Obama proposed to fund fewer, not more, positions. Consequently, medical students will begin to outnumber available residencies as early as next year.

The solution is not to demand that Congress fund more residencies. Instead, state-level policymakers should tear down the protectionist walls erected by professional associations that seek to keep salaries high by suppressing the number of new doctors, nurses, and medical technologists and limiting their abilities to serve patients.

These entrenched special interests use their power in state legislatures to maintain restrictive “scope of practice” regulations that, to cite one example, make it impossible in many places —including Michigan — to open low-cost clinics in Wal-Mart stores staffed by highly trained nurse practitioners. Expanding the scope of practice for midlevel professionals like nurse practitioners and physician assistants would expand the pool of quality health care services available in a state while lowering the cost to receive them.

Special interests also resist the adoption of retail and direct primary medicine. Retail medicine involves a medical professional setting up business in a store front, offering affordable, convenient treatment on an as-needed basis. Direct primary medicine offers a subscription-type model in which a patient pays a fixed monthly rate to a health care provider, encouraging more focus on prevention and maintenance of chronic conditions. States should encourage new models that cater to the needs of different types of patients.

It will take a combination of solutions to resolve the physician shortage, and their unifying theme should be “service.” The criteria for training good health care providers should focus on the needs of the patients — we should not prop up an ineffective model of health care delivery for the benefit of incumbent practitioners. As our population ages and advanced treatments allow patients with chronic illnesses to live longer, policymakers and industry professionals must work together to remove barriers to entry in the health care field, and to free the market to meet changing needs.


TOPICS: Government
KEYWORDS: doctors
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1 posted on 04/13/2016 5:55:29 AM PDT by MichCapCon
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To: MichCapCon

Change!

Fundamental transformation!

Wheeeeeee!!!!


2 posted on 04/13/2016 5:57:49 AM PDT by E. Pluribus Unum ("If voting made any difference they wouldn't let us do it." --Samuel Clemens)
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To: MichCapCon

Now don’t get sick or anything!


3 posted on 04/13/2016 6:10:27 AM PDT by elcid1970 ("The Second Amendment is more important than Islam. Buy ammo.")
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To: MichCapCon

This shouldn’t be a problem. Just have some sort of typical Fed “job training “ program for some aspiring ferals. They should be really good doctors in only a few months.


4 posted on 04/13/2016 6:15:46 AM PDT by hal ogen (First Amendment or Reeducation Camp?.)
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To: MichCapCon
The answer is limited government as established by the Constitution.

In a nutshell if done correctly nearly 90% of the government we have today including personnel, budget, laws, regulations, control and ownership of real estate and so on would simply be gone. Those powers and resources would be returned to the states or the people.

Do this and in 20 years there will be no doctor shortage

5 posted on 04/13/2016 6:19:30 AM PDT by precisionshootist
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To: elcid1970

And don’t ever use your healthcare.... that you are paying hundreds of dollars a month for.

It is major Heck working with the insurance companies these days.


6 posted on 04/13/2016 6:22:53 AM PDT by dhs12345
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To: MichCapCon

The politization of medicine is about to begin.


7 posted on 04/13/2016 6:25:20 AM PDT by BRL
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To: MichCapCon

The physician shortage induced by Obamacare will be ‘fixed’ in the same ways that the Brits fixed their NHS-induced shortage. Choke off demand by delay, delay, delay, combined with admitting under-trained 3rd worlders to practice.


8 posted on 04/13/2016 6:37:01 AM PDT by Paine in the Neck (Socialism consumes EVERYTHING)
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To: MichCapCon

If Obamacare was about your health they would have hired 10,000 more doctors instead of 10,000 more IRS agents


9 posted on 04/13/2016 6:43:30 AM PDT by Mr. K
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To: MichCapCon

Once Obamacare is ended, the very fastest way to get doctors into practice is for the government to facilitate doctors going into private practice, with no insurance, Medicare or Medicaid.

Likewise, government needs to facilitate hospitals that work on a cash basis, except for high end and acute care paid with insurance, and exempt from federal and state regulations of having to provide indigent care.

Then, and only then, the facilitation of exclusively Medicare or Medicaid or insurance practices.

The HIPAA and HITECH Acts need radical reform to keep governments nose out of personal health care, along with a Doctor-Patient Confidentiality Restoration Act.


10 posted on 04/13/2016 6:45:15 AM PDT by yefragetuwrabrumuy ("Don't compare me to the almighty, compare me to the alternative." -Obama, 09-24-11)
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To: MichCapCon

It started in and by Clinton Administration.


11 posted on 04/13/2016 6:48:41 AM PDT by victim soul (victim soul)
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To: MichCapCon

A couple of years ago, an Internal Medicine clinic in my town of 14k lost two IM doctors within a few months. One quit to move to a hospital organization because of the paperwork and regulations under Obamacare.

So far, the only remaining doctor has not found replacements willing to come to this town. Instead, many patients are treated by an A.P.R.N. (Advanced Practice Registered Nurse).


12 posted on 04/13/2016 6:48:55 AM PDT by TomGuy
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To: MichCapCon

I didn’t notice her going after the medical schools to lower their tuition


13 posted on 04/13/2016 6:51:32 AM PDT by nuconvert ( Khomeini promised change too // Hail, Chairman O)
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To: Mr. K

That is the best comment ever made about on ObamaCare.

Should be sent to every news outlet and talk radio host.

“If Obamacare was about your health they would have hired 10,000 more doctors instead of 10,000 more IRS agents”

That is so spot on.


14 posted on 04/13/2016 7:19:27 AM PDT by jcon40
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To: TomGuy

Physician extenders are the future.

I expect in 10 years, most nonsurgical types will just be managing a herd of NPs and PAs. Although the NPs are vying for independent practices in most states.


15 posted on 04/13/2016 7:20:14 AM PDT by dangerdoc ((this space for rent))
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To: MichCapCon; All

There’s another, and fairly easy solution that would help a great deal. Many nurses can be trained/elevated to nurse practitioner. A great deal of regular internal medicine/family practitioner stuff can be handled by them. And as most medical practices today are large, they’re always be an MD around if one was needed.


16 posted on 04/13/2016 7:22:12 AM PDT by ken5050 ("Black Female Army Captain" is the adopted daughter of "Deep in the Huertgen Forest")
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To: MichCapCon

Executive order?


17 posted on 04/13/2016 7:24:11 AM PDT by cp124 (Trade, Immigration, Intervention)
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To: dhs12345
Thank goodness we all got that $2500/yr savings as promised by BHO.

/s

18 posted on 04/13/2016 7:31:58 AM PDT by BipolarBob
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To: MichCapCon

A medical doctor told me recently that it’s a myth that doctors drive Cadillacs. Nowadays, he said, they drive Tauruses.


19 posted on 04/13/2016 7:58:57 AM PDT by Fiji Hill
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To: MichCapCon

During the 1990’s, Hillary said we had too many doctors.


20 posted on 04/13/2016 8:10:09 AM PDT by aimhigh (1 John 3:23)
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