Will There Really Be a Doctor Shortage?

healthcare reformMy Comments: There is one already. An unintended consequence of ObamaCare ( the PPACA ) is that millions of people who have until now waited until the last minute and then went to an Emergency Care Center are now trying to get appointments with MDs who were already busy people. Not enough people are yet in the pipeline to provide medical care.

And it’s not just MDs. I’ve had several conversations with CPAs who are increasingly frustrated by their inability to find willing and qualifed accountants to come and work with them. Many are in their 60’s and looking to retire and get away from the grind but are unable to find successors.

I don’t know how all this is going to play out, since the demographics alone is going to create a greater and greater problem. All the baby boomers who became physicians 40 years ago are ready to do something else, just when the rest of us need more and more medical attention.

Dec 2, 2014 Arlen Meyers, MD, MBA

The conventional wisdom seems to be that we will be facing a doctor shortage due to the 10,000 boomers turning 65 each day, disparities in geographic distribution and inappropriate specialist/generalist ratios. Add that to the bottle neck in graduate medical education funding and the pundits would have you believe you’ll need to go the black market to find a doctor in the future.

Some have cast doubts, though. Here’s why:

1. There has not been enough pain spread around to all the players to motivate change. The expectation is there will be in the near future.

2. Patients are becoming more and more accepting of physician substitutes , extenders and advanced practice professionals

3. The care delivery channels and business models are changing requiring fewer doctors or less skilled professionals to execute them

4. Necessity will drive innovation, particularly with population health management tools applied to the 20% of Medicare recipients who account for 80% of the costs.

5. A shift from a sick care system to a health care system might lesson demand

6. Rethinking end of life care would reduce the demand for services.

7. The shift from hospital based care to community and home based care will drive the need for non-physician substitutes.

8. One- on- one care is migrating to team based care.

9. Surrogates and families are being given the technology tools to support aging at home initiatives.

10. The realization that doing what we are doing now and paying what we are paying will bankrupt the country and severely compromise our global competitiveness.

Healthcare manpower prognostications, to paraphrase Yogi, are notoriously unreliable particularly when they involve predicting the future. When it comes to doctor supply, don’t go all in or necessarily believe everything you click.

Arlen Meyers, MD, MBA is a Professor at the University of Colorado School of Medicine and President and CEO of the Society of Physician Entrepreneurs at http://www.sopenet.org and ceo@sopenet.net.

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