While we continue to see news stories that illustrate the impending physician shortage that is impacting communities all over the United States, the thing we don’t hear enough about is what can be done about it. The main reason for the lack of information about ways to reverse the doctor shortage is because much of it relies on federal intervention. To refresh your memory, in 1997 as part of a Balanced Budget Act, Congress enacted legislation to cap the number of residency training slots to be funded through Medicare. Now, twenty-two years later, the limitations are effectively inhibiting the training of enough new physicians to keep up with the increased care demands of a growing population and an elderly population that is living longer.
A recent comprehensive study presented key findings to include, a projected physician shortage by the year 2032 of up to 121,900, and population growth of 10% with those over age 65 increasing by 48%. The report did identify that there would be a continuation in the growth of physician assistants and advanced practice RNs. Good news on the surface, but the report found that emerging health care delivery trends in addition to the increased use of advanced practice providers would only contribute to a physician demand reduction of about 1% overall. Considering all of these factors, let’s look at what can be done to solve the physician shortage.
Enact legislation to reverse the residency training limits.
There are currently two bills that were introduced in the House of Representatives and one bill introduced in the Senate that will increase the numbers of residency slots by up to 5,000 per year for the next five years. While this should be welcome news that physician shortage relief is on the horizon, the current ultra-partisan state of our legislative branch means that like so many other pieces of legislation, no action is being taken on the bills. All three of these legislative items are sitting in a preliminary status after having been introduced earlier this year. Concerned citizens can take action and contact their federally elected representatives and ask them to move on the Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348) and also the Opioid Workforce Act of 2019 (H.R. 3414).
Continue to develop ways to improve physician utilization.
As previously mentioned, there is a growing utilization of advanced practice providers, such as physician assistants and other specialty practice providers, like certified anesthesiologist assistants and others. Extending a physician’s reach through improved and increased utilization of technology solutions, like telemedicine, is another cost-effective way to improve access in underserved communities. One interesting advancement currently being used in France is a standalone telemedicine booth, called a Consult Station. Inside, a patient is connected with a physician, via video, and has access to an array of diagnostic medical devices. Guided by the physician, the patient can perform a variety of health checks, including vital signs, blood oxygen levels, an electrocardiogram, and other tests. These stations are in use throughout France and have improved access to medical care for many underserved rural communities.
Embrace the utilization of new technologies.
Like France has done with the implementation of the Consult Station, the United States must take action to embrace and increase the efficiency of implementing new technologies. From streamlining the training, licensing, and certification process for new innovations to increasing the utilization of computer-assisted medicine, artificial intelligence, and sensor technology. As today’s healthcare consumers become more and more connected, they are increasingly active in monitoring their own care and are more open to accepting technologies as part of their healthcare experience. Technological innovations can supplement the increased utilization of advanced practice professionals and help bridge the gap in direct physician interventions.
There is no simple answer to the challenge of alleviating the physician shortage in the United States. It is going to take a multi-faceted approach that includes participation and funding from both the private and public sector. What can’t be overstated, however, is the fact that the trending pace of the shortage is far exceeding the pace of actions being taken to address the matter. Until, a concerted effort is taken at the federal, state, and local level, access to care gaps will widen, and healthcare consumers will continue to bear the burden of the inaction.
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