There is rising debate of whether or not America has a doctor shortage. As with most vigorous discussions, there is data to support both sides of the argument. When the data is presented around the aging of our population and the number of physicians retiring, compared to the number of new doctors joining the work force and their full-time equivalent status, things look bleak. However, when you look at the redundancy of care in our system, physicians doing tasks that they do not want to be doing and should not be doing, the counter argument can be made. When you layer on new technology, consumer desire to be more in charge of themselves and new models of care delivered by other types of providers, one might even argue there is an oversupply of physicians.
There are some interesting new facts emerging. The number of NPs and PAs are growing, as well as the number of RNs. The number of medical school graduates has increased 30% over the past 10 years and matriculation is as competitive as ever. Granted, the number of residency slots has not increased, so there is now a backlog of MDs that are not matching.
There is definitely a distribution issue. There are parts of our country where physicians are not succeeding due to competitive issues while other parts of the country are woefully underserved. The same can be said concerning disparities amongst those with and without insurance. These latter two issues can be fixed in multiple ways including regulatory changes concerning scope and location of practice, technology, and payment reform focused on disparities.
We need to look at this issue with solutions in mind, not whether or not there are enough doctors. A positive consequence of rightsizing what our physicians are asked to do, creating new models of care, and delivering this care by the appropriate people, at the appropriate place, and at the appropriate time will be doctors might feel less burn out and have the joy of medicine return.
My hope is that as we move forward towards delivering value to those we serve in new and creative ways, many of these issues will be addressed. If we move in such a direction, we will not be talking about shortages; we will not be talking about doctor burn out. Am I sounding aspirational? Absolutely. Is it possible? Absolutely. We need to focus on the work force needed for the future based on an optimal way of delivering care that is holistic, focused on what is needed, and is reverent to the needs of those we serve and of those we ask to serve. So I ask the question again, is there a doctor shortage?