Shortage of 65,000 to 150,000 physicians nationwide by 2020

  1. [color=#2c5d8f]blurring the line: medical spas, other fields luring primary care docs

    in "creating a new national workforce for internal medicine," the acp asserts that roughly 21 percent of physicians who were board certified in the early 1990s have left internal medicine, compared with a 5 percent departure rate for subspecialists. meanwhile, only 13 percent of first-year internal medicine residents indicated they intend to pursue general internal medicine.

    stafford attributes the problem to an eroded reimbursement level for primary care services that "rewards procedures over talking."
    seeing an influx of np's into internal medicine practices in philadelphia area over past 2 years.....interesting.
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  2. 9 Comments

  3. by   HARRN2b
    We need to increase immigration. Does no one want to go to med school anymore? What are they leaving medicine for? academia? research? wall street?
  4. by   cabkrun
    Quote from HARRN2b
    We need to increase immigration. Does no one want to go to med school anymore? What are they leaving medicine for? academia? research? wall street?

    You have got to be kidding. The answer isn't more cheap labor from overseas, the answer is payng/reimbursing people what they are worth. Doctors don't go into Primary Care/Internal Medicine anymore because they can't afford to. Immigration will only exaccerbate the problem, just as it has nursing.
  5. by   azhiker96
    Part of the problem has to be the way our government contains medical costs. They simply pay less for procedures. It's no wonder some docs refuse to take clients on Medicare. What if nurses were paid in the same manner? Can you imagine report? "Here's your patients. Oh BTW, they are all on Medicare so you'll only get $4.50/hr for this shift, courtesy of the Government. Have a nice night!"
  6. by   aquarius4u
    shortage?? Based on what i see there is and it will get worst..
    why?? correct me if i am wrong ,but these are my thoughts re: this issue
    1) new med. grads would rather do subspecialty because it pays more thus they will be able to pay college debts faster (more or less about 100k)
    2) reimbursement costs are going way down the drain and usually 50% of what they earn goes to overhead and please don't forget Uncle Sam.
    3) malpractice costs are skyrocketing because of our SUE FRIENDLY environment( sad to say , it is quite rampant now a days)
    4) baby boomers are increasing in numbers
    5) most of female docs usually work part time when they have kids
    6) many are retiring early or slowing down due to some of the above pressures
    7) primary care docs nowadays has an option to work as a hospitalist because of a better schedule.
    8) and the very touchy issue IMMIGRATION...yes, they are tight now for foreign docs to come in. in my own opinion, we need to take care of the NOW problem especially when we are dealing with healthcare issues. i witnessed a lot of times that people are having a hard time getting a primary care physician because mostly they can not see new patients anymore. that being said, are we going to wait xx yrs for them to be seen?? also, it takes so much MONEY ,TIME ,EFFORT , and DEDICATION to be one. most doctors finish their training when they are already on their late 20s or early 30s starting with loads of debt on their shoulders while some of their age peers are thickening retirement funds.Our pedi. is a foreign grad but she is pretty darn good! personally , i don't have any problems with foreign doctors.
    unfortunately, medicine is a trial and error. every day is a learning process .what we think as best treatments for today may be a major screw up 3 yrs down the road or even sooner... sad thing is it deals with human life!
    who wants to do medicine when after so much MONEY spent, HARD WORK ,AND SACRIFICE you will end up in a court room for prescribing celebrex?Sad to say ,but it is REALITY!
  7. by   cabkrun
    Granted, some solid points. However, importing doesn't solve the problem, it just masks it. Foreign docs can get sued and get ****** reimbursements just as well as U.S. docs. And....sorry to say, it SHOULD be tough to practice medicine!. Yep, sue happy as we are, it's a shame that I see a doctor from L.A. write in an article about medicine that "every patient that walks into my office I view as a potential lawsuit". That's a sad statement on our society.
    See the NYT's article on Philipino nurses being given the nursing exams from their "coaches" before they actually take them, so they know the answers?
    So, there are no easy solutions to the shortage, but seems we gotta fix what's causing them in the first place, and it's the whole managed/health care system and no reimbursements, etc. Importing people while not addressing the problem, is IMHO short-sighted. Lots easier said than done, for sure...but what a mess we've created
  8. by   Roy Fokker
    Quote from cabkrun
    You have got to be kidding. The answer isn't more cheap labor from overseas, the answer is payng/reimbursing people what they are worth. Doctors don't go into Primary Care/Internal Medicine anymore because they can't afford to. Immigration will only exaccerbate the problem, just as it has nursing.
    That's not true.

    Physicians are usually given visas based on area of need - typically, under-represented and under-served areas of the US get assigned foreign physicians (in an effort to boost healthcare in the area).


    This "cheap labor" theory is unsubstantiated - be it nursing or medicine. It has perhaps beein pointed out hundreds of times by dozens of people on this very board - nurses (and physicians) cannot be hired for "cheaper wages" because they work on "Permanent Resident Status". By Law, emplyers HAVE to pay the same wages they pay US citizens.
  9. by   cabkrun
    Okay, not going to start an argument. Those types of things are what they said with the IT shortage too.
  10. by   aquarius4u
    my say..
    what we probably need to do is try to to control malpractice lawsuits and lower down education fees for medical school then we can have more docs.
    yes, there are some scholarships/financial assitance but in reality, it is hard to acquire financial assistance if your parents income are considered "fine".

    also,some people abuse the system and and file lawsuits for purely monetary gain..

    roy fokker, very good point...
    why would our country let foreign docs in? because they were and are needed in the first place.and yes it is not cheap labor, income wise we all earn the same. I still stand by my previous post re: this matter

    i strongly believe my reasons because i experienced it first hand.My husband has a lot of foreign doc collegues that are highly respected in their field and income wise it is the same.

    again , more monetary assistance to the deserving for medical school and control/screen malpractice lawsuits(ongoing process) ..maybe then we will have more medical students.
  11. by   aquarius4u
    cakrun.. i definitely agree with you re:"it should be tough to practice medicine!" because again as i said earlier you are dealing with human life!

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