Did you know that the United States is going through a physician shortage?! Currently, there are about 293 doctors to every 100,000 patients. This would normally be an OK doctor-to-patient ratio, except for the fact that only about 88 out of that 293 are primary care physicians. Primary care physicians are the pediatricians, family doctors, and internal doctors that one would see when you have a cold or some other common ailment. The other 205 in that doctor-to-patient ratio are specialist physicians whom often get a little extra training in order to focus on one area of medicine, such as neonatal specialists or neurologists.
So, why the shortage in primary care physicians? Well, professionals in the health sector have attributed this shortage to the considerable difference in salaries between primary physicians and specialists. Specialists generally make at least double of what primary doctors will make per year; seeing as most medical students pay for tuition through loans, more money is a huge selling point. There also is an unfounded stigma that primary physicians belong at the bottom of the ‘physician totem pole’, and new up-and-coming doctors seldom want to settle after eight years of consecutive schooling.
Okay, now we know some of the reasons why this shortage has come about, so why is it such a big deal? Well, in an article I found on Fortune.com (see link below) Shawn Tully compared primary care to oil in an energy market; if there is no oil the energy market will fail to function, and if there are not enough primary care physicians the health care market will fail to function. Receiving attention from any specialists is almost always preceded by some form of primary care, so consider primary doctors as the first tier in a large, hierarchical (and admittedly chaotic) health care system. Without enough primaries working at the first level, the system becomes stunted, unorganized and muddled!
What are we to do you ask? Since the situation is expected to worsen, there have been a number of initiatives from organizations such as the American Medical Association (AMA) and the Association of American Medical Colleges (AAMC) to encourage new medical professionals to enter primary care, and also help those physicians who are already being overwhelmed in the field. The AMA is trying to push the formation of ‘accountable care organizations’ (ACO), which would help bridge the gap between primary and specialty care through expediting the processes involved in primary care (such as compiling electronic medical records, creating specific protocols, and assigning patients particularly suited primary physicians). The AAMC is considering creating institutions specific to primary care in an effort to entice new medical students with new residency positions and state-of-the-art facilities.
According to the AAMC, in 2020 the US will be 900,000 physicians short than what is recommended—the majority of those being primary physicians. If change is to happen, it has got to happen soon!