Longer waits, shorter appointments, and new options outside the medical practice.
The demand for American doctors will fall short anywhere from 46,000 to 90,000 by 2025, making the shortage perhaps the foremost healthcare crisis today.
“The doctor shortage is real – it’s significant – and it’s particularly serious for the kind of medical care that our aging population is going to need,” said Association of American Medical Colleges (AAMC) President and CEO Darrell G. Kirch, MD.
What this mean for you is hardly clear cut. But one area where the shortage will be felt, as Kirch notes, is geriatrics. He says at least 3,000 more doctors a year will be needed to meet the healthcare needs of a huge wave of aging baby boomers.
“We are not prepared as a nation. We are facing a crisis,” Heather Whitson, MD, associate professor of medicine at the Duke University School of Medicine in Durham, N.C., told U.S. News.
“Our current health care system is ill equipped to provide the optimal care experience for patients with multiple chronic conditions or with functional limitations and disabilities.”
One reason for the shortage is that primary care doctors are aging along with their patients, and they are retiring in large numbers.
If you live in a rural area, you know it’s already a problem and has been for many years. Doctors tend to remain in areas where they are trained, and the vast majority of those areas are metropolitan. The medical centers in metropolitan areas also tend to offer more attractive work options that entice young doctors to stay.
A study conducted for the AAMC by the Life Science division of IHS, Inc., a global information company, also projects the rapid growth of non-physician clinicians and new payment and delivery models, such as patient-centered medical homes and accountable care organizations.
Projections for individual specialties were aggregated into four broad categories: primary care, medical specialties, surgical specialties, and “other” specialties. Within the overall projected doctor shortage, the study estimates a shortage of 12,000 to 31,000 primary care doctors, and a shortfall of 28,000 to 63,000 non-primary care doctors, mostly among surgeons.
“The trends from these data are clear — the physician shortage will grow over the next 10 years under every likely scenario,” said the AAMC’s Kirch.
For John Q. Public, the shortage will likely mean that finding a doctor at all will be more difficult, and getting in to see the one you already have will take much longer.
"A survey [from] The Physicians Foundation," the Associated Press noted, "found that 81 percent of doctors describe themselves as either over-extended or at full capacity, and 44 percent said they planned to cut back on the number of patients they see, retire, work part-time, or close their practice to new patients."
InsWeb, a website for healthcare insurers, says the shortage of primary care doctors will send more people to emergency rooms for serious illnesses or injuries.
In turn, by not having access to primary care when they need it, patients are likely to “develop more serious or chronic illnesses that might have been avoided with preventive care,” InsWeb says.
A 2008 study by the American College of Physicians found that access to preventive care can reduce hospital stays, decrease the cost of care, and lead to overall better health and longer lifespans.
Primary care is extremely important for patients with chronic illnesses such as diabetes, which must be closely monitored. When diabetes isn’t treated, it can lead to many complications, such as kidney failure.
You’re already seeing some options that are springing up to fill the gap in physician care. In many pharmacies today, you can find a small clinic with nurse practitioners who can take care of basic primary care needs.
Other options include urgent care centers, nurse-led practices in states that allow them, team-based care that takes the pressure off doctors to provide all the attention each patient needs, and practices with physician assistants.
One area sure to grow in reaction to the shortage is telemedicine. There are about 800,000 remote video visits in urban areas annually already, according to the American Telemedicine Association.
"Patients increasingly will want to take advantage of advances in mobile technology via their smartphones and remote monitoring," Don Goldmann, MD, chief medical and scientific officer at the Institute for Healthcare Improvement in Cambridge, Mass., told the Chicago Tribune.
Patients find telemedicine is convenient and saves time, while doctors can cut down on overhead, spend more time with patients, and carry a bigger case load, especially with team assistance. Over the phone, through an app, or via a laptop, doctors can diagnose a condition, prescribe medication, or advise patients to visit a specialist or an emergency room.
If you don’t have a regular primary care doctor now, you should. Consistency of care is paramount to your health.
You should look for a doctor “the same way you interview a lawyer or an accountant," Don Powell, president of the American Institute for Preventive Medicine, told U.S. News. "People know more about how to buy a car than they do about selecting a doctor."
February 19, 2020
Janet O’Dell, RN