Where Expectations Meet Frustration

Physicians wonder: what has happened to focusing the practice of medicine on patient care?

By Pamela McKemmie | Remarks | September/October 2008 | Your Voice

 

Physician Shortage an Increasing Concern

Data from government sources, the American Medical Association (AMA), the Council of Graduate Medical Education (COGME), and physician specialty associations indicate there has been a growing “silent shortage” of physicians in a number of specialties for the past few decades.

AMA data show that 318,459 physicians, or 44 percent of the total population of physicians in patient care as of year-end 2006, are age 55 or older. For example, the mean age of U.S. radiologists is 61.7, according to the AMA. The mean age of physicians practicing psychoanalysis is 70.6, while the mean age of psychiatrists is 52.5.

U.S. medical schools have trained an average of 15,500 physicians a year since 1980, according to the Department of Health and Human Services. In a June 2006 report the Association of American Medical Colleges (AAMC) called for a 30 percent increase in accredited medical school enrollment by 2015.

The AAMC also recommended eliminating the current Medicare restriction on the number of funded residency positions so that graduate medical education programs can accommodate more graduates of accredited U.S. medical schools.

Meanwhile, the population continues to grow. U.S. Census data indicate a population increase of close to 24 percent between July 1, 1988 and July 1, 2008, from approximately 244.5 million people in 1988 to more than 300 million people in 2008.

In an October 2006 report entitled “Physician Supply and Demand: Projections to 2020,” the U.S. Health Resources and Services Administration projected a shortfall of 55,100 physicians in 2020, primarily among non-primary-care specialties. A year earlier the Council of Graduate Medical Education had released a report predicting a shortage of roughly 85,000 physicians by 2020, caused in part by our aging U.S. population.

According to the June 2007 issue of Managed Care magazine, “The American Academy of Family Physicians last year recommended that to meet the need for primary care physicians in 2020, the United States would have to train 3,725 family physicians and 714 osteopathic physicians annually, with an overall goal of a 39 percent increase in family physicians. The American College of Physicians, which represents internists, supports the call for training more doctors but has not issued specific recommendations for increasing the number of internists.”

More Questions Than Answers

Juxtaposed with these figures, our research results raise some interesting questions about the future of medical practice. Will the healthcare policies of the new administration exacerbate an already noticeable shortage of physicians across the nation? What incentive will there be for future generations to pursue medical degrees? And what’s going to encourage those legally qualified to practice medicine to pursue patient care?

In what Wall Street Journal “Health” blogger Jacob Goldstein called a “zeitgeist,” a July 21 New York Times story chronicles how a Richmond, Virginia nephrologist, Arnold Kim, MD, this month quit practicing medicine to focus on his MacRumors blog full-time. The hobby he picked up eight years ago while getting his $200,000 medical education reportedly now attracts 4.4 million visitors and 40 million page views per month. While Kim says each occupation earns him a six-figure income, he gets to work from home and enjoy time with his 14-month-old daughter as a blogger.

Clearly, Marcus Welby, MD has left the building.

A founding partner of Georgia-based LocumTenens.com, Pamela McKemie has worked in physician recruitment for more than 15 years.

 

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