Doctor Shortage-Who Should Fill the Gap?

I have to say that whenever I hear there is a "shortage" of any kind of worker I am suspicious. What this usually means is "we are not willing to pay a salary commensorate with skill level, education and responsiblity and therefore do not have enough people to fill the available slots" But perhaps this is too long to write and thus the word "shortage" must be used. LOL

Pay the salary all the other little doctors are getting to play the medicine game and you will quickly see a dearth of primary care doctors. However, in the lets keep health care affordable game, its best to keep reimbursements for primary care low. That way you keep most MDs out so that you do not have to come up with their exhorbident (sp?) salaries and you can instead fill in with PAs and NPS that are paid good but not astronomical salaries. Spinning it with the "shortage" angle makes it easier to tout the "necessity" of midlevels doing primary care.

In the defense of MD's, they have massive amounts in loans and need to make a high salary to pay them back any time before they are fifty. I am sure it is not fun to be walking around at 35 with $200,000 in loans hangin over your head. On the other hand at the salary most specialists make they can no doubt pay this off in short order. NPs and PAs on the other hand are not in this level of debt.

I truely believe a better system would be to do loan paybacks for all these providers corresponding with how long they are willing to practice. But if that happens, will we see a mass exodus to primary care and PAs and NPS out on the street?

A couple viewpoints I read is that NP/PA don't have as much training as medical students and they could misdiagnose patients. How many times have we heard about doctors who misdiagnose patients? That's not a good reason to not use NP/PA. There are plenty of NP/PA who have many years hospital experience and the education to take the place of primary care physicians. I disagree with the physician who said importing foreign doctors will solve the solution. It has me wondering what would be in it for him.

Unfortunately, I think the trial lawyers will see a move to more PAs and NPs as a cash cow.

Medical insurances need to increase payment to the internal medical physicians. This would increase the number of internal medical physicians. The role of the internist would be able to focus on health prevention of diseases, ie. obesity, diabetes, lung disease. Time would be a lotted for MD to be an MD instead of seeing too many patients in a time frame.

This coming from a person that was in pre-med before I decided that nursing was the correct way of life for me, I can completely see why there is a "shortage" of these professionals.

In the UK when you graduate "high school" you're told whether or not a certain field would be a good fit for you. While this seems demeaning to hear "you'd be a great refuse hauler", sometimes people need that reality check. There's SO many people that go into the field and have no business being in it. That being said, what they also do is have THEIR students enter into the coarses that are pertinent to the medical field right out of high school. They don't have this "4 years of pre-req" BS that we have here in the states. Because of this they don't have the amount of debt (4 years less of schooling) that our docs have, and they're also getting into it 4 years faster than we are. This is a breakdown, at least partially, of the system we have here in the US.

This is the way it was when I went to school - don't know if that's the way it still is, but I'd venture to gain it still is.

As far as importing physicians from across seas, why the HECK is this considered a good idea?! I can't understand 1/2 or greater of the docs that I talk to on the phone already!

Actually the cost part in education is relative. A grad from a state medical school could posibly have less dept than an NP/PA from a private school. Although the NP/PA from the state school would have the same relative dept.

I enjoyed reading the CNN article and looking at the different viewpoints.

Michael Jones (Physician Assistant) made a comment that experienced (10+ yrs) midlevels should be able allowed to sever their ties to physicians in order to lower the costs to patients. I am curious to know if the cost savings would be passed on to the patients or if they will just pocket the difference?

I also enjoyed reading the doctor's and the medical student's defense of their turf.

C

Interesting when the nursing shortage is up for discussion, the immediate answer is to import nurses. Yet the foreign doctors want to come over to the USA as nurses. Why because medicine has made it very hard for foreign doctors to come to the USA.

I thought the nurse shortage was bigger than the physician shortage. So everyone is going to move up one level? MA's covering the nurse shortage, nurse covering the MD's shortage and MD's only specializing (no primary care--> FM, IM, Peds or OB/GYN)!!