At RealClearPolicy Thomas Hemphill and Gerald Knesek take note of a predicted shortage of family care physicians:
Over the last decade there has been increasing concern about an impending shortage of primary-care physicians. The most cited study projecting a shortage of these doctors (whose specialties include internal medicine, family medicine, and pediatrics) was published by the Association of American Medical Colleges Center for Workforce Studies in 2008, and its projections were updated in 2010 to take account of the Affordable Care Act. Lost in the dire warnings is an equally alarming shortage of non-primary-care physicians: The same organization puts the numbers at 33,100 this year; 46,109 by 2020; and 64,600 by 2025.
They go on to consider several strategies for dealing with the situation.
To my mind the shortage of family care physicians highlights the problem of simultaneously trying to treat healthcare as a a market-based economy and a command economy. It is not and cannot be a market-based economy without drastic reform. The supply is capped by a politburo, for goodness sake. The reason there’s a shortage of family care physicians is that family care physicians aren’t paid as highly as many other specialties, med students, understandably, are edging away from family practice towards better-paid specialties, and the medical schools and hospitals are allowing that.
There’s a simple solution to the problem: recognize that healthcare is a command economy and command. Amend the Medicare law to increase the number of paid residencies for the family care specialties (a more bizarre formulation than “family care specialties” can hardly be imagined), reducing the number of paid residencies for other specialties as needed. Or, alternatively, the federal government could just deny accreditation to medical schools that fail to meet their quota of family care physicians.
A friend of my wife had a son in medical school. He came out something like second in his class. Then he decided to go into radiology, confirming his brilliance!
Actually, radiology is a poor choice. It’s one of the specialties most likely to be outsourced offshore.
Maybe in the long run, but not now. And in the meantime, he avoids all the icky parts of medicine, mainly dealing with patients.
Also, I believe the AMA will probably have the clout to combat off-shoring. They’ve done better than most in fighting wage pressures from foreign workers, for example.
A house divided against itself, etc. I already know of hospitals and practices that are offshoring radiology and pathology.
At the New Orleans VA, they send a lot of imaging and test results to Arkansas for evaluation before you are allowed to be seen by a specialist, and for the yearly diabetic eye exam, I think it goes there as well. They are still not finished with the new hospital, and this may be why.
I am waiting for them to say, “we will need to send your EKG to Arkansas before we can do CPR.” I am just kidding. I love my VA and all my non-bonus VA people. They get me.
For whatever it’s worth, my wife left family Medicine due to the working conditions more than the money. Which itself is related to the shortage. Fewer FPs means more hours means fewer FPs means…