Doctor Shortage...How Do We Fill the Prescription?

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

The recent health care insurance reform passed by Congress gave hope to the millions of people who could not afford to insure themselves or their loved ones; but the forgotten part of the equation is that there might not be doctors to provide that care. The problem is that there aren't enough primary care physicians in the United States and the supply isn't going to catch up with demand any time soon. According to the Association of American Medical Colleges, there may be a shortage of 150,000 doctors in the next 15 years.

The numbers game begins with the length and expense of training a doctor. Usually a four year undergraduate degree is the entry requirement to four years of medical school, which is followed by three or more years of residency training to become a primary care provider like a family doctor, pediatrician, or internist. If all 18,000 students who entered medical school this year decided to practice primary care, it would take 11 years for them to see their first patient. If we kept that rate up for a decade, perhaps the physician manpower needs would be met. But what would the country do without the surgeons, cardiologists, obstetricians, psychiatrists, and other medical specialists whose ranks would be depleted?

The need to provide basic medical care, to have a place for a patient to call home, has been lost in the ever more specialized world of Western medicine. Primary providers spend much of their time coordinating the care recommended by other specialists and trying to prevent fragmented advice that is confusing to the patient. Often patients are uncertain as to whose advice to listen to, who their "regular" doctor might be, and whom to call with questions. With more pressure on doctors to expand their practice to add the newly insured, even less time will be available to spend with each office visit.