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  1. #1
    USIMG2011 is offline Member 510 points
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    Is there a Doctor Shortage in the USA?

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    I was wondering if there is a doctor shortage in certain regions of the US. I keep hearing that some state medical boards help repay student loans for those students willing to work in specific locales that have a doctor "shortage". Is this true? I am in Australia right now and I know firsthand that there is a serious shortage of doctors in the country. There are quite a few US trained doctors working in Australia, I even met a Caribbean graduate who is working as an OB-GYN here. I was wondering if there are parts of the US that have a similar need such as the Midwest, Southeast, Alaska and others.

  2. #2
    Shah_Patel_PT's Avatar
    Shah_Patel_PT is offline Senior Member 510 points
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    Quote Originally Posted by USIMG2011 View Post
    I was wondering if there is a doctor shortage in certain regions of the US. I keep hearing that some state medical boards help repay student loans for those students willing to work in specific locales that have a doctor "shortage". Is this true? I am in Australia right now and I know firsthand that there is a serious shortage of doctors in the country. There are quite a few US trained doctors working in Australia, I even met a Caribbean graduate who is working as an OB-GYN here. I was wondering if there are parts of the US that have a similar need such as the Midwest, Southeast, Alaska and others.
    There are no shortages at present...but shortages are anticipated as the baby boomer generation of doctors start to retire, at the same time..the greatest segment of population in the USA that is increasing...are the elderly! So more docs will be needed for them as well.

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    ///M5 is offline Junior Member 510 points
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    there is a great post on this in sdn

  4. #4
    ROCKYMAN is offline Junior Member
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    wrong again.

    Quote Originally Posted by ****_Patel_PT View Post
    There are no shortages at present...but shortages are anticipated as the baby boomer generation of doctors start to retire, at the same time..the greatest segment of population in the USA that is increasing...are the elderly! So more docs will be needed for them as well.
    Please do not give inaccurate advice. By either of two different standards of measurement, there is definitely a shortage of doctors today. I define those statistically as Target Access (a target of optimum health care access for all Americans) and Discretionary Access (minimum access to what Americans have had during the previous decade). There is an immense doctor shortage in the United States if defined by Target Access to health care, and, if only defined by Discretionary Access, at health care facilities from private offices to clinics and hospitals, a documented decrease in physicians for some "populations" has ALREADY occurred. There are hundreds of small communities which can not afford to have one physician. Emergency rooms have closed in the recent ten years. 40 MILLION persons in the United States do not have health insurance. The health "status" of United States has fallen sharply. America has also been assaulted by 12 million illegal aliens, who, when they need "regular" health care, do not get it, but instead become sicker and eventually are seen at Emergency Departments, whether or not they are in the emergent category. County hospitals have had to struggle, considering the economics imposed by insurers and governments, to provide the expected standard of health care for its taxpayer base, and are unable to cope with the added burden of providing free care for illegals. Federal law requires emergent patients to get emergency care, regardless of ability to pay. But emergency care is only a part of the system. Clinics of every type are overloaded. Americans, in spite of having excellent medical technology, have declining general health status. Fast food. Sedentary lifestyle. Stress.

    A growing population of sicker and financially poorer people has been demanding the latest medical technology as the quantity of primary care physicians decreases. I hypothesize that Americans are sicker than they need to be partially because of the shrinking access to primary care.

    The best care is only guaranteed for the wealthy. Everyone else has no access, low access, or decreasing access. Additionally, the expensive war in Iraq has not only drained the United States financially, it has distracted United States citizens and Congress from the agenda of "fixing" the health care system.

    Though the situation will get critical as the "baby boomers" age, the shortages were noticed in some areas a few years ago.

    The doctor shortage was partially designed and controlled by the A.M.A. to "maintain" salaries, but the A.M.A. is under pressure to address the problem, and the slight increase in medical school seats during the recent 5 years was a drop in the bucket compared to the size of the problem.

    I quote from one of the articles:
    'Even the American Medical Association (AMA), the influential lobbying group for physicians, has abandoned its long-standing position that an "oversupply exists or is immediately expected."'

    The A.M.A. president was sneaky in evading the problem, stating he did not know if there was a shortage. Everybody else knows, however.

    The Medical College of Wisconsin published a valuable graph indicating the expected decline in doctors. The graph is in the article at:

    USATODAY.com - Medical miscalculation creates doctor shortage

    Thus, whether one defines a doctor shortage by an inadequate supply of doctors for the positions needed (advertised employment) in health care facilities (a problem), or by an inadequate supply to meet the optimum health care needs of the United States (an outright crisis), the answer is YES, THERE IS A DOCTOR SHORTAGE TODAY. Technology is improving but access to basic health care is decreasing. As the situation worsens, a crisis will occur in meeting BASIC health care needs, as typified by access to a "family doctor". Forget the elective surgery, there are already millions of people who can not get influenza immunization.

    Worse, new graduates do not want to work in primary care, and the same study showed that those with the best Step 1 scores avoid primary care like the plague. Do a little googling, Patel, I am shocked Ross is about to graduate you without you having better skill in evidence-based Medicine.

    If anyone has a doubt about the doctor shortage, it is best to read articles about people who have gotten sicker or had a loved one die as a result of inadequate access to doctors.

    Earlier in the year, the American Association of Family Physicians reported:
    "Between 1997 and 2005, the number of medical school graduates who enter the primary care field decreased by more than half as more graduates enter specialties with higher pay and more control over work hours, the report finds."

    Sadly, I have observed in my colleagues at Ross quite a few medical students who seek employment in the United States seem uninterested in helping average Americans and only interested in cash or "social status". Medicine is not about a caste system of social status, Medicine is about serving Humanity. I claim there has been a negative change in the "corporate culture" of physicians.

    A few interesting articles:

    CHCs Struggle With Physician Shortage -- AAFP News Now -- American Academy of Family Physicians

    www.abc.net.au/worldtoday/content/2006/s1638775.htm

    Health Workforce: Scottish doctor shortage Scotland,British Medical Association,Davis, Clive,Consultants, nhs, healthcare, ahp, recruitment, redundancy, staff, doctors

    Doctor shortage looms large on the stage for health care - Nashville Business Journal:

    futureofinnovation.org/PDF/Benchmarks.pdf

    www.azcentral.com/arizonarepublic/news/articles/0724drshortage-main24USE.html

    Cheers.
    --------------------------------------------------------------------


  5. #5
    USIMG2011 is offline Member 510 points
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    Family Practice

    I think many FM physicians are following the business model approach to healthcare themselves. I know my own Family doctor has more than five offices, and it seems to run like a business. Even primary care doctors are not immune to the market. Its the effect of having a private health care system. Whatever happened to helping people?

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    djnitin's Avatar
    djnitin is offline Senior Member 510 points
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    I don't think you can call the declining quality of healthcare a shortage of doctors. They are not exactly the same thing. And quantity doesn't necessarily mean quality.

    The closing of emergency rooms has been shown to be related more to economics than the actual lack of physicians.

    If we were really short of doctors in this country, we would just steal some more from developing countries such as India, Philippines, Jamaica, and South Africa.

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    DrVinsk is offline Permanently Banned 510 points
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    Sadly, I have observed in my colleagues at Ross quite a few medical students who seek employment in the United States seem uninterested in helping average Americans and only interested in cash or "social status". Medicine is not about a caste system of social status, Medicine is about serving Humanity. I claim there has been a negative change in the "corporate culture" of physicians.

    Unfortunately what you have described is the overwhelming number of uknowwhos who are coming over to the US to practice. I have been with these doctors and they are in general rude and impassionate towards their patients. They have a childish attitude about social status there and sadly they carry it with them when they come here.
    Last edited by DrVinsk; 11-19-2006 at 01:03 PM.

  8. #8
    Water's Avatar
    Water is offline Member 519 points
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    Rockyman, you seem to know your information well. I enjoy reading your posts; however, blatantly dismissing someone make you come across arrogant. Physicians need to more tactful in their appraoch because they work with patients, housekeepers, cnas, pcts, etc. Tactfulness not only making you a good physician, it only makes you a good colleague, collaborator, and teacher.
    Yes there is a major shortage of physicians in the United States. Although nursing shortage is more prominent and better known to the public than the counterpart. To remedy this issue, many physicians know train nps in specialties such as pulmonary, cardiology, endocrinology, etc. to help them work with more patients. This seems to temporarily address the issue; however, as stated by Rockman, the Babyboomers wil skyrocket the geriatric population plu the extended life expectancy. Hence, more healthcare providers are needed in the future.
    Another issue with healthcare is an uneven distribution of health care services in a limited supply society. Take for example, rural communities have few physician per number of rural dwellers. Poor transporation delays treatment, primary prevention, and so on. In addition, healthcare facilities continue to struggle in rural communities.
    In addition, malpractice insurance has driven some specialties out of certain states. For example in Nevada, I heard several Ob/Gyn physicians left there last year because of the malpractice insurance coupling with diagnosis related group reimbursement.

    USIMG2011, I think you are just kidding. Regardless, stealing physicians from other countries is unethical and selfish. The US has been remedying its nursing shortage issue in the United States by taking nurses from Asia and Euroupe. There has been limited impact on European coutries; however, Philipines has suffered a major nursing shortage due to the exportation of nurses. We take their best nurses. Who fill up these spots in their respective countries? similarly, we are starting to do the same thing with lab technicians.
    By the way, stealing physicians from other country is more difficulty than what most people think. Foreign healthcare providers have to overcome language barrier and cultural shock. In addition, the USMLE is tough. I know a physician who speaks perfect English, yet, he can not pass the USMLE. I also know another one who knows USMLE content well, but he can not pass it. Why? language barrier.
    In medicine, we should not just treat the symptoms; rather, we should go to the root cause and solve the problems. There should be an increase in educators and facilities who train more healthcare providers.

  9. #9
    teratos's Avatar
    teratos is offline Jedi Moderator 658 points
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    Quote Originally Posted by USIMG2011 View Post
    I think many FM physicians are following the business model approach to healthcare themselves. I know my own Family doctor has more than five offices, and it seems to run like a business. Even primary care doctors are not immune to the market. Its the effect of having a private health care system. Whatever happened to helping people?
    In primary care, your income is driven by the number of patients you see. Reimbursements are going down for many private insurers. Medicare keeps threatening pay cuts. They only way to stay on top of the game is to see more patients. You have to pay for the rent, the staff, their benefits, upkeep, malpractice insurance and supplies before you take home a dime. Nobody wants to go into primary care anymore. Helping people is a good thing, but you have to eat as well. I think if primary care docs didn't have to worry about making sure they have enough to take home, you may find the caring spirit come back.

    Some may argue that primary care docs make plenty. > $100,000 should be enough for anyone, right? People often go into medicine to make a better life for themselves and their families. There is a certain expectation regarding lifestyle and income that people have, and that is getting harder and harder to meet. It may seem selfish, but we are all selfish creatures to a point. You are much more likely to extend yourself to help other people once you have met all of your perceived needs yourself. G
    AUC Class of '99
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    I may be a jerk, but I'm a Jedi jerk like my father.

    Some say I look like Buzz Lightyear....
    (They're right)

    DISCLAIMER: I have no financial stake in ValueMD, or any medical school.

  10. #10
    jim
    jim is offline Elite Member
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    you want to know if there is a doc shortage? give your name to a headhunter or two,a nd prepare to get inundated with job offers. though very comfortably employed, i still get on average 5 messages a day by phone or email offering interviews. when i was actively seeking work, that average number was closer to 50 a day.

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