Is there a doctor shortage?

H/T @roccodesta

Preview

1. New docs go unmatched every year.

It is not well known but not every med school graduate gets matched with a clinical residency. And without that residency, these very well educated folks are not allowed to see patients or practice medicine. Mostly due to malpractice ins. restrictions. 

Some match the following year when they reapply. Some will find positions in research. But too often, they leave the field out of necessity.

Finding a way to get these doctors treating patients would help the perceived shortage.

2. Not every patient requires a physician.

There are highly qualified Nurse Practitioners, Physicians Assistants, and other health professionals qualified and capable of handling many primary care and some advanced care areas as well. More patients seen sooner.

3. Are patients accessing their health care the “right way”?

There are multiple routes of accessing medical care. From calling EMS services, to visiting an ER or urgent care, to an office visit with your primary or specialist provider.

It is important that patients and the public receive education to understand which route is appropriate.  And when.

4. Two out of Three Ain’t Bad

I had a Doc with an Emergency Medicine Fellowship explain the economies of medicine too me. Since that time, I've witnessed these same dynamics play out in hospitals, clinics, and even individual practices.

There are three main metrics the public uses to decide how satisfied they are with their care. 

Speed: How quickly was I able to see my care provider? How quickly was I treated?

Quality: Did I receive "good" care? Did the provider(s) seem competent and caring?

Cost: How much did I pay? How much did insurance or the govt pay? Did it effect my taxes or premiums?

This can be summed up with We want our medical care to be Cheap, Fast, and Good.

That is the ideal. The reality is any system can only give you two out iof those three. The designers of the system, with input from all stakeholders (including patients) have to decide which two of these the need to prioritize. And then do the best they can on the third.

5. Level the playing field for primary care physicians.

It is a fact of life that a primary care physician (ie. Family Practice, Pediatrics, Emergency Medicine, etc.) is almost guaranteed to work longer hours, see more patients, and earn less money than most other specialists. As a result, there are far fewer young doctors interested in primary care. This may lead to the perception of a doctor shortage.