Stories of emergency rooms pushed to capacity and wait times at physicians' offices have become legendary. Now the passage of healthcare reform — potentially funneling 30 million new people into an already-packed system — has some groups warning that the nation will soon see a shortage of doctors.
The Assn. of American Medical Colleges has warned of a deficiency of up to 125,000 doctors by 2025.
Though estimates and degrees of pessimism vary, most healthcare providers and healthcare delivery expertsagree that, at some point, there will be a strain in primary care. And the problem goes further than mere doctor counts. Among the other complicating factors: a misaligned distribution of physicians between discliplines (too many neonatal doctors, for example, and too few general surgeons); increased health needs of aging baby boomers; and disagreement over how much of the gap can be filled by physician's assistants and nurse practitioners, professions where there also are shortages.
"This will be the first time since the 1930s that the ratio of physicians to the population will start to decline," said Dr. Atul Grover, chief advocacy officer for the AAMC. "The number of people over 65 will double between 2000 and 2030, and the amount of medical services they require is two to three times higher than many other adults."
The reason? Money. A physician providing a 30-minute office visit is reimbursed $103.42 by Medicare, while a diagnostic colonoscopy — which takes about the same amount of time — nets $449.44, according to Bruce Steinwald, director of healthcare for the Government Accountability Office, in testimony he gave to the Senate Committee on Health, Education, Labor and Pensions in 2008.
A pediatric ophthalmologist makes half the income of one working with adults, Phillips said. And if a medical student chooses to go into primary care instead of a subspecialty like cardiology, which pays more, they will lose $3.5 million in income over a lifetime, he added.