AAMC Panel Demystifies the Doctor Shortage
May 6, 2014
The doctor shortage, how the academic medicine community is addressing it, and what Congress can do to fix it were the topics of a May 6 briefing on Capitol Hill organized by the Association of American Medical Colleges (AAMC). With the growing, aging population, the U.S. is poised to face a physician shortage in the next decade, and a panel of experts emphasized the importance of addressing the shortfall across all medical specialties.
“Primary care is the foundation for a high-performing health system, giving millions of Americans a way to manage chronic conditions and prevent the progression of others,” said Atul Grover, M.D., Ph.D., chief public policy officer at the AAMC. “In addition, the shortage of specialists could prevent the burgeoning population of older Americans from getting the care they need to treat cancer, diabetes, strokes, and other ailments with a higher frequency amongst the elderly. Taken together, both pose a significant problem for the future of health care delivery in the United States.”
To emphasize the impact of the shortage and illustrate that Congressional action to lift the cap on Medicare support for residency slots will help combat it, briefing attendees participated in a simulated “Match Day.” Upon opening their Match letters, they learned that not all graduating medical school students will be able to complete their training right away and become independently practicing physicians. Through mock physician profiles, they also learned about the personal and complex nature of selecting a specialty and residency program.
Dr. Grover began the briefing by explaining why the U.S. is facing a shortage of more than 91,000 physicians by the end of the next decade. While factors like increased insurance coverage, a growing population, and increased utilization due to medical advances are part of the story, the driving force is the aging U.S. population. As the Baby Boomers age, they will need more doctors at the same time that Baby Boomer physicians are retiring.
“If we don’t train more physicians, we will experience a decrease in doctors right as we will be needing more,” Grover said. “We have known for a while that demographics was driving the shortage.”
Dr. Grover also outlined the process for training physicians, and reminded the audience about their potential fate as they opened their Match envelopes. “Just because you want to be a licensed physician after graduating from medical school doesn’t mean you’ll get to be. You need a residency slot to complete your training.”
H. Hunt Batjer, M.D., Darwin E. Smith Distinguished Chair in Neurological Surgery at the University of Texas Southwestern Medical Center and president-elect of the American Association of Neurological Surgeons and the Society of Neurological Surgeons, gave his view of the physician shortage from the perspective of his specialty. An aging population of surgeons and increased demand for specialty care—especially by older Americans—could exacerbate an already troubling maldistribution of surgeons.
MeroŽ Morse, M.D., a primary care-internal medicine resident at New York University Langone Medical Center, discussed why she chose to become a primary care physician and work at the Michael E. DeBakey Veterans Affairs Medical Center in Houston upon completion of her residency.
“Every physician has a story to tell as to why he or she chose to practice medicine, and I have found over the years that the reasons physicians go into medicine are multi-faceted and more complex than most people would think. In my case, the choice to become a primary care doctor was a circuitous decision process influenced by experiences from my upbringing, my personal interests, my lifestyle needs, mentors who guided me along the way, and ultimately, consideration of the type of relationship that I wished to have with my future patients.”
The panelists also discussed the value of the current residency system and training at large teaching hospitals, as Dr. Batjer stressed the importance of team-based care to treat the whole patient, and Dr. Morse extolled the opportunity to “see the full spectrum of disease and what a critically ill person looks like, even if I’m going into primary care.”
Currently, there are three bills in Congress (H.R. 1180, H.R. 1201, and S. 577) that would help address the doctor shortage by increasing residency slots by 15,000 over five years. This increase would account for one-third of the doctors necessary to meet the country’s workforce needs. In addition to expanded federal support for residency training, the AAMC also has supported studying and investing in team-based approaches and new models of care as part of a comprehensive strategy to address physician shortages.