“Healthcare is an ever-growing field.” I’ve heard this for at least the last decade. And this statement is definitely true—if not more so now than it was ten years ago.
With the Affordable Care Act taking effect soon and the aging population increasing at an alarming rate, healthcare shortages are almost guaranteed. So unless some serious reformations and advancements are made, healthcare will continue to be a growing field.
Physicians: hit the hardest
An area of interest to me, personally, is the specialties that will be hit the hardest by today’s looming shortage. By 2020, there is projected to be a nationwide physician shortage of over 90,000—over half being primary care physicians—according to the new Association of American Medical Colleges workforce projections. The rate of graduating generalist physicians, which includes family practitioners, internists, and pediatricians, is declining rapidly, and has been doing so for almost two decades. One reason for this is that the majority of medical students are going into fellowships after residency rather than going right into a profession in primary care. This is happening for a variety of reasons but primarily it’s due to salary versus workload, work-life balance and simply the status of being highly specialized.
Physicians take a huge amount of risk daily, so to want to be compensated for that is only natural.
When will the wait be over?
There are serious implications for such shortages. The mere ability to get an appointment with one’s primary care physician is difficult, and the longer wait times (weeks sometimes even months) to get an appointment cause more people to head for the ER, even though their condition could easily be handled at the office. Subsequently, ER’s are getting bogged down with non-traumatic patients, which, if persistent will cause medical costs to skyrocket for insurance companies and Medicaid/Medicare.
Primary care physicians are often referred to as gate keepers for the medical specialists. They direct traffic, so to speak, and send patients to specialists as they see fit. Specialists rely on these referrals as a large portion of their patient base. With people going to emergency rooms, hospital employed specialists are getting all of the referrals, which down the road will cause serious damage to the private practice industry.
Finding the cure
The American Medical Association (AMA), medical schools and universities alike are working on ways to combat some of today’s healthcare issues and are working to prepare physicians for the medicine of the future.
There are great strides being made to streamline the educational process as well as to make the primary care profession more attractive to new grads. But, one part of the equation is being overlooked—the lack of residency programs. Many states are building new medical schools but they haven’t created new residencies. Minor problem…and inconveniently enough, new residencies are funded primarily by the Centers for Medicare & Medicaid Services—the same federal agency that’s under extreme budget pressure and is responsible for the provision of benefits to millions of individual beneficiaries. So now what?
One approach, the American Medical Association is campaigning to “accelerate change in medical education”—a topic that has most medical schools more than all ears. They want to pick 20–30 proposals from medical schools to expand on their ideas. From that, they then would like to pick 8–10 of the full-length entries to be awarded a portion of the $10 million grant initiative. According to the AMA, the winners will be graded on “established criteria”—along the lines of the level of innovation and potential impact offered by the proposal, the strength of the idea and the design and the likelihood that other schools could implement the proposed idea.
The intent of this initiative is to facilitate bold structural change over five years at each selected school to support a significant redesign of undergraduate medical education.
There are also new programs emerging that condense medical education from four years down to three. Though this is not a new idea, it’s a good one. Some programs even allow medical students to complete their first year of residency while finishing their last year of medical school. Such a reduction could potentially save each student over $50,000 in tuition, supplies and living expenses. This type of accelerated program would be attractive for physicians who just want to get out and start working—and could help balance the current inequality of primary care physicians versus specialists.
Rest assured that there are movements being made to combat the huge healthcare deficiencies projected in a short seven years. Only time will tell if they prove to be successful. But, I’m convinced that healthcare is and will continue to be an ever-growing field.