We have a severe problem in our current healthcare system. According to one report, the United States will have a shortage of approximately 90,000 doctors by 2025. Physician shortage is a crisis with devastating implications for our healthcare system.
Here are the facts from the report: supply of physicians is growing! Unfortunately, demand is growing much faster. The report explains that America could be short 30,000 primary care physicians by 2025. Even worse, the shortage will hit surgery-related specialties the hardest.
The report also highlights other issues that could magnify this problem. First, by expanding healthcare coverage, the Affordable Care Act (ACA) has increased demand dramatically. Second, baby boomer doctors are starting to retire en masse. Third, there is evidence that millennial doctors work fewer hours than doctors from previous generations.
What does this mean for our healthcare system? Well, it could mean that waiting times increase, quality decreases, and costs rise.
If there are fewer doctors to care for an ever-increasing number of patients, waiting time will increase. Already, procedures, and major surgeries in particular, need to be scheduled two to three months out at minimum. That time could vastly increase because there simply will not be enough surgeons.
Quality could be an issue because doctors would have overwhelming schedules. This would increase stress and strains on physicians’ mental health–and that increases the possibility of mistakes. From my own experience as an intern in a neurosurgery clinic, when a doctor has thirteen or fourteen patients on his or her schedule in a single day, it is difficult to give every patient the time they deserve. Doctors, unfortunately, are not superheroes who can add hours to the day or magically make problems go away. When a schedule is that full, the quality of health care declines.
Finally, costs will rise if the physician shortage continues as projected. This is simple economics. If there are more people wanting the same service and fewer people that are performing that service, the service is going to become more expensive. That is especially bad news for working class and middle class families who may not be able to access the full array of healthcare options.
How do we fix this problem? While there are no easy answers, here are a couple of things we can do to decrease the physician shortage:
First and foremost, we have to make medical school more accessible. In 2006, the average medical school debt was around $120,000. Less than a decade later, that figure climbed to approximately $180,000.This is a clear deterrent to students pondering a career in medicine. They likely would want to start a life, buy a home, and possibly have a family after graduation, but they would be left with a $180,000 crutch. Let’s emphasize loan repayment solutions and work with medical schools to keep costs down.
The Association of American Medical Colleges released a report on student loan repayment that deserves more attention. More people should know, for example, that medical school loans can be completely forgiven by working in places of national need or entering the military as a doctor. Student loans do not have to cripple a doctor’s life, but unfortunately, not enough young physicians and potential medical school applicants are aware of the creative ways to repay loans.
Working with medical schools gets a little more tricky. Potential cost-saving solutions include sharing faculty among geographically close universities, allowing more courses to go online, and applying work-study to medical schools. One program that is particularly promising is income-share agreements for medical school. A prospective student would attend medical school for free and then pay between three and nine percent of their future income for a fixed amount of time. Depending on how the agreement is set up, the person may pay a bank, the school, or the government. Similar to a flat tax, the people who can afford to pay back a little more do and those that cannot pay back the same amount do not have to because it is simply a small fraction of their income for a fixed amount of time. Everyone pays the same percentage of their income, regardless of what that is, for a short period of time.
Finally, there is one concrete act all of us can do to limit the physician shortage: tell our doctors they did a good job and thank them for making a difference in our lives. I cannot tell you how many people I saw walk through that neurosurgeon’s office without thanking him for his services. It might seem trivial, but if people started doing it more, I think physicians would stick around longer and be willing to work more hours. Caring for the sick and injured on a daily basis is a taxing job. Let’s make sure doctors feel appreciated through regular expressions of gratitude, because a little positivity can relieve a lot of stress.