Not Enough Doctors, or Too Many Doctors?

[Ashi]

This site says

"the medical education system produces about 8,000 new doctors per year, but 35,000 become eligible for retirement. The math doesn’t work. Worse, low job satisfaction levels have many younger doctors considering leaving their careers."

Various states also report doctor shortages (which I won't bother linking).

However, this is a very balanced view (in my opinion) which is an interview with a surgeion.

Basically, he says 3 things:

1) We are going into a medical school expansion right now, since everyone says there aren't enough doctors.

2) But, he says there are actually already too many doctors. It's just that they don't all go into the specialities we need (general doctors in particular). Also, not enough want to work in the poor areas since they'll make less.

3) There aren't enough incentives to go into the specialties/areas where we need doctors. So the system imbalance will remain unless these problems are fixed.

Some Excerpts:
"The scenario isn't one of overworked doctors struggling to keep up with the demands of patients waiting in line for care. Rather, it's a hyper-competitive world of doctors in the same specialty fighting over a limited supply of patients.”

"When the Council on Graduate Medical Education (COGME) warns that we need to train more physicians to meet the demands of aging baby boomers, the Council assumes that the current national physician-to-population ratio is optimal. Those who call for more physicians “never examine the relationship between physician supply and the health of patients and population” notes Dartmouth’s Dr. David Goodman in a 2005 Health Affairs article, “The Physician Workforce Crisis: Where Is the Evidence?”

"Take a look at the evidence, and it’s clear that the conventional wisdom is wrong. As I’ve discussed in the past, in areas of the country that boast more specialists, patient outcomes are worse—even after adjusting for differences in age, race and the overall health of the population."

“If improving the health and well-being of the population remains our goal we need more generalists and fewer specialists, today and in the future.”

"today’s surplus of specialists means that too many specialists are chasing too few patients...If I were to suddenly disappear from the face of the earth... the other surgeons here would be more than willing to swoop in and score my referral base"

"he is also realistic enough to understand that increasing medical school enrollments is not the answer: “You'll just end up with proportionally more cardiologists, more gastroenterologists, more cardiac surgeons to flood an already supersaturated metropolitan market. Until we compensate primary care/family practice in such a way as to make it financially appealing to medical students, there's still going to be physician shortages in South Dakota and Southern Ohio and Rural Kansas.”

[Ashi]

http://www.nytimes.com/2007/11/07/business/07care.html?_r=1&8br&oref=slogin

Less than 8 percent of medical school graduates chose family medicine this year, according to the academy of family doctors.

Health policy experts say that unless payment and practice rules are changed, the financial squeeze on primary care doctors threatens to produce a crisis for patient care. As the population ages, it needs more care, but primary care doctors are becoming scarce in many parts of the country.

So the problem is similar to in the sciences, it's not too few total doctors, it's too few qualified doctors for certain specializations.

[Chris]

Let's discuss this more!