Q: How many doctors does it take to screw in a lightbulb?
A: More than we have. At least that's the implication of this LA Times article, which reports on the looming physician shortage. The number of medical school graduates has remained steady for about the last 25 years, capped because the industry feared creating too many graduates in an age of HMO's and declining salaries. Unfortunately, demand is exploding, both because of the baby boomers and the ever-increasing number of treatments demanded by patients. And the situation will only get worse: a full third of the nation's 750,000 doctors are readying to collect their own Social Security, and will be retired before the boomer wave crests. Meanwhile, younger doctors have no interest in letting their jobs be as all-consuming as the last generation did, and are thus expected to prove 10 percent less productive. So we'll have fewer doctors, and the one's left won't treat as many patients.
So what's going to happen? Well, wait times, for one. Folks already wait months diagnostic procedures, and that's only going to get worse. At the moment, a dermatological appointment in requires an average 24 day wait, gynecologists take 23 days, cardiologists 19, orthopedists 17. When my friend recently needed a complicated knee surgery, the wait was months. Tell me again about the horrors of Canada. Additionally, prices will go up, and time with physicians will drop. Caseloads for good doctors will fill up and close, and rural and underserved areas will lack alternative options. And because physician training takes so long, and requires so many resources, quick adjustments can't be made. Some of the slack could be filled by nurse practitioners , but there's little effort to do so. And, in case you were wondering, America averages 2.3 physicians per 1,000 residents, well below the OECD average of 2.9. Just another benefit that comes from spending double what anyone else does for less than everyone else gets.
