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Government Struggling to Address Physician Shortage

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We’ve discussed the physician-shortage crisis extensively on this blog from its many different and occasionally confusing angles. There are those who say it’s worse than anything you could imagine. There are those who say that its impact is exaggerated, and as people become healthier, the shortage will decrease. In one case, we zeroed in on rural Georgia, where the physician shortage is a life-threatening problem for which no one seems to have any satisfactory answers.

Perhaps rural Georgia is our best reference point for this story from last Monday in the USA Today by Kaitlyn Krasselt and Jayne O’Donnell, headlined “Doctors shortage worsening, demand growing.”

The physician shortage crisis may not be a problem in some regions of the country, but across the nation, as seen in Georgia, it is becoming more than a crisis; it’s becoming an epidemic.

In its second paragraph, the article outlines yet another reason why: “The U.S. is expected to need 52,000 more primary care physicians by 2025, according to a study by the Robert Graham Center, which does family medicine policy research. But funding for teaching hospitals that could train thousands more of these doctors expires in late 2015.”

As with so much in the new healthcare reform paradigm, this fact is simply counterintuitive to the demands being made by the Affordable Care Act, including the population growth that it has spurred.

Naturally, the government claims to have answers. In this case, it is relying on expansions to primary care that are currently in “President Obama’s budget working its way through Congress…which includes nurse practitioners and pediatricians. The ACA, [HHS] says, significantly increases the number of primary care providers in underserved areas and increases Medicare and Medicaid payment for services delivered by primary care practitioners.”

There is a little-mentioned caveat, however. In this case…

“ACA funding that added 600 new primary care residencies was part of a five-year investment that expires at the end of 2015, eliminating the chance to produce hundreds more doctors each year.”

Before you begin to foment at the mouth over the sheer inadequacy (to put it generously) of the government’s “answers” to the crisis, rest easy, for others are already fomenting. In short order, the response has been as follows:

1. Why not increase oversight on the $12 billion currently in flux for federal graduate medical education (GME) funding? (HHS says its hands are tied by Congress, who controls the GME funding formula.)

2. Why not address the skyrocketing costs of medical school, which places some students in a money pit of debt frequently as deep as $250,000?

3. Why does Medicare and Medicaid “tend to reward specialty, interventionist care over prevention, primary care, and diagnosis…,” especially in light of the fact that “[f]amily physicians made an average of $175,000 in 2012, the third lowest of any doctor…” Yet primary care physicians are the ones needed most by the crisis!

4. Why not speed up the process by which practice laws are rewritten to allow advanced practitioners to administer vaccinations and strep tests, taking these responsibilities off the backs of overly burdened physicians?

These are just four of the areas the government and HHS need to address in lieu of hoping for a Congressional budget miracle. These are just four of the areas in which healthcare reform itself needs to be reformed.

As physicians looking for jobs, how do you view the physician shortage crisis? How does it affect your job search? Is it easier to get an interview? How overly burdened are you now in your current position because of the crisis?

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