The Association of American Medical Colleges in a recent study has projected that there will be a doctor shortage between 42,000 and 120,300 by 2030. This is a stunning number when you break down the fact that the shortage will affect primary care doctors (14,800 – 49,300); specialists (33,800 – 72,700); and surgical sub specialists (20,700 – 30,500). The looming crisis is magnified by the fact that increasing demand from a both a growing and an aging population must be considered.
How did we get to this point? Perhaps it is because Congress passed The Balanced Budget Act of 1997 which limited the number of residency positions in the US. Because of this, there are doctors who graduate from medical school each year, who cannot be licensed to practice medicine because they cannot find a residency. Physicians must complete at least one year of residency to be eligible to practice medicine. Instead of taking care of patients in underserved communities, these doctors are unnecessarily sidelined.
The solution to the problem has been a movement towards changing the healthcare workforce. The delivery of healthcare has morphed into a team approach where nurses and physician assistants and now artificial intelligence have become the drivers in the belief that each member of the healthcare system is interchangeable. However, is this belief based on fact or convenience?
In the haste to control costs and expand access, basic questions have been virtually ignored: Are physicians really interchangeable? Will patient care be affected by the absence of the physician? Will moving towards virtual medicine (such as telemedicine) and precision medicine based in population, artificial intelligence and algorithms work for the individual patient? Will using allied health professionals with a different scope of training lead to better outcomes for a patient with a complicated medical problem?