1. Welcome to Religious Forums, a friendly forum to discuss all religions in a friendly surrounding.

    Your voice is missing! You will need to register to get access to the following site features:
    • Reply to discussions and create your own threads.
    • Our modern chat room. No add-ons or extensions required, just login and start chatting!
    • Access to private conversations with other members.

    We hope to see you as a part of our community soon!

Doctor shortages are here

Discussion in 'Health & Healing' started by sun rise, Nov 24, 2022.

  1. sun rise

    sun rise Śvāna Dharma
    Premium Member

    Joined:
    Apr 28, 2014
    Messages:
    74,443
    Ratings:
    +38,583
    Religion:
    Love/Omnism
    How the American health care system is not supplying enough doctors leading to delays, some lengthy, in getting care.

    Doctor shortages are here—and they’ll get worse if we don’t act fast

    The U.S. faces a projected shortage of between 37,800 and 124,000 physicians within 12 years, according to The Complexities of Physician Supply and Demand: Projections From 2019 to 2034 (PDF), a report released by the Association of American Medical Colleges (AAMC).

    Specific AAMC projections by 2034 include shortages of:
    • Between 17,800 and 48,000 primary care physicians .
    • Between 21,000 and 77,100 non-primary care physicians.
    This includes shortages of:
    • Between 15,800 and 30,200 for surgical specialties.
    • Between 3,800 and 13,400 for medical specialties.
    • Between 10,300 and 35,600 for other specialties.
     
    • Like Like x 1
  2. Shaul

    Shaul Well-Known Member
    Premium Member

    Joined:
    May 18, 2016
    Messages:
    6,359
    Ratings:
    +3,017
    Religion:
    Judaism
    • Winner Winner x 1
    • Optimistic Optimistic x 1
  3. sun rise

    sun rise Śvāna Dharma
    Premium Member

    Joined:
    Apr 28, 2014
    Messages:
    74,443
    Ratings:
    +38,583
    Religion:
    Love/Omnism
    You quoted an 11 year old analysis not the state of the art today. And did you compare the recommendations 11 years ago with the current practice? To wit what I highlighted below has come to pass - we can see Nurse Practitioners for ordinary health care and in some cases for ordinary followup.

    With expanded access to primary care for millions of new patients, physicians and policymakers face increased pressure to solve the perennial shortage of primary care practitioners. Despite the controversy surrounding its enactment, the ACA should motivate organized medicine to take the lead in shaping new strategies for meeting the nation’s primary care needs. In this commentary, we argue that physicians should take the lead in developing policies to address the primary care shortage. First, physicians and medical professional organizations should abandon their long-standing opposition to non-physician practitioners (NPPs) as primary care providers. Second, physicians should re-imagine how primary care is delivered, including shifting routine care to NPPs while retaining responsibility for complex patients and oversight of the new primary care arrangements. Third, the ACA’s focus on wellness and prevention creates opportunities for physicians to integrate population health into primary care practice.
     
    • Like Like x 2
  4. Brickjectivity

    Brickjectivity Turned to Stone. Now I stretch daily.
    Staff Member Premium Member

    Joined:
    Dec 8, 2012
    Messages:
    36,558
    Ratings:
    +16,719
    Religion:
    liber-scripta grim Christian
    Also, as a patient you have very little value. You're not paying. The insurance company is paying, and so you simply do not matter.

    But even with top notch insurance I could get an appointment only three weeks ahead of time. I was there early and had everything signed. Despite my appointment I was enclosed to wait in a noisy waiting room for a indeterminate amount of time with noisy rude people. There were 5 sources of music ongoing simultaneously from damned cell phones, plus crying children, plus some guy humming loudly to block out the sound and I was supposed to wait for my name to be called. The room smelled of alcohol. I waited over 1/2 hour in maddening noise, before I canceled.
     
    • Like Like x 2
  5. Twilight Hue

    Twilight Hue Twilight, not bright nor dark, good nor bad.

    Joined:
    Mar 7, 2009
    Messages:
    47,665
    Ratings:
    +21,489
    Religion:
    Philosophical Buddhism
    And is that happening? Nope. That is not happening.
     
  6. Shadow Wolf

    Shadow Wolf Certified People sTabber

    Joined:
    Apr 11, 2005
    Messages:
    87,613
    Ratings:
    +40,474
    Religion:
    God is in the Rain
    Is that why many clinicians have committed fraud so treatment can be obtained?
     
    • Like Like x 2
  7. Shadow Wolf

    Shadow Wolf Certified People sTabber

    Joined:
    Apr 11, 2005
    Messages:
    87,613
    Ratings:
    +40,474
    Religion:
    God is in the Rain
    I can assure you, some positions have faced a chronic shortage even before the ACA. It's partly why America has so many physicians who came here from another country.
     
    • Like Like x 2
  8. It Aint Necessarily So

    It Aint Necessarily So Well-Known Member
    Premium Member

    Joined:
    Mar 1, 2017
    Messages:
    8,850
    Ratings:
    +11,405
    Religion:
    None
    I can share one American ex-physician's perspective, which may help explain some of the problem.

    I remember moving to Columbus, OH to attend OSU with the hope of going to its medical school upon receiving my BS there. I lived in an apartment owned by an elderly GP, who still made house calls at age 80 carrying a black bag. I thought that that would be me some day if health permitted.

    Medicine was all I hoped it would be for the first few years, but then came HMOs, which made the physician an advocate for the insurance company rather than the patient if you wanted to play that game, and decreased payment, respect (we became providers along with the nurse practitioners and physician's assistants), and autonomy, while increasing the time it took to get things done and liability with some corporation trying to share management privileges without sharing liability.

    Then Clinton balanced the budget in part with significant Medicare payment cuts to physicians, which I accepted as a necessary sacrifice to make for the good of the nation, until Bush came along and declared two wars while giving his buddies tax cuts. My desire to contribute to America dropped to zero then.

    Then came a requirement to go digital with medical records, which costs about $40,000 for a private practice given the necessary hardware, proprietary software (the government should have provided it free) and converting existing paper records to digital. That's an expense that generates no revenue, unlike a treadmill or Holter monitor.

    By that time, I was disgusted with America and not just because of the changes in medical practice there, so I radically changed my plans from working fifty years if I could to getting out as soon as possible, retiring at 25 years (2009) and saving the forty grand. Other physicians were also miserable then, and there was a major exodus from medical practice. I don't know what the conditions are today for American physicians, but I'm not surprised that people don't want the job as much anymore and that there is a shortage.

    I thank America for that, strangely enough. I would never have retired early because I had always felt like I had a skill that came with a duty. I would still be working in Missouri today instead of having spent the last 13 years in leisure in paradise. I would have considered that a selfish choice, but America convinced me that its government was working against my interests in favor of those of corporations like the HMOs and those selling electronic medical records software, and that I owed it nothing any longer. Our social contract was null and void, so I was free to do what was best for us. I couldn't get out of there fast enough. I likened it to the scene from Forest Gump when Forest is discharged, and runs out the door (jump to 1:22)

    :
     
    • Winner Winner x 2
    • Friendly Friendly x 1
  9. Shaul

    Shaul Well-Known Member
    Premium Member

    Joined:
    May 18, 2016
    Messages:
    6,359
    Ratings:
    +3,017
    Religion:
    Judaism
    And the analysis holds up. The shortages it envisioned came true.
     
  10. Sand Dancer

    Sand Dancer Crazy Cat Lady

    Joined:
    Jan 12, 2013
    Messages:
    6,881
    Ratings:
    +4,535
    Religion:
    Agnostic Buddhist
    Are you in Mexico?
     
    • Friendly Friendly x 1
  11. Brickjectivity

    Brickjectivity Turned to Stone. Now I stretch daily.
    Staff Member Premium Member

    Joined:
    Dec 8, 2012
    Messages:
    36,558
    Ratings:
    +16,719
    Religion:
    liber-scripta grim Christian
    I am unsure if I catch your meaning. Fraud in order to help people get treatment?
     
  12. Shadow Wolf

    Shadow Wolf Certified People sTabber

    Joined:
    Apr 11, 2005
    Messages:
    87,613
    Ratings:
    +40,474
    Religion:
    God is in the Rain
    Yes. When insurance says no for whatever reason and a clinician lies in the paperwork so treatment can be covered.
     
    • Informative Informative x 1
  13. Twilight Hue

    Twilight Hue Twilight, not bright nor dark, good nor bad.

    Joined:
    Mar 7, 2009
    Messages:
    47,665
    Ratings:
    +21,489
    Religion:
    Philosophical Buddhism
    That's been the case since the 70s.
     
  14. It Aint Necessarily So

    It Aint Necessarily So Well-Known Member
    Premium Member

    Joined:
    Mar 1, 2017
    Messages:
    8,850
    Ratings:
    +11,405
    Religion:
    None
    Yes, full time since 2009. We live on a large lake a mile up in the Sierra Nevadas.

    upload_2022-11-25_7-54-20.png upload_2022-11-25_7-55-20.png upload_2022-11-25_7-55-51.png upload_2022-11-25_7-56-31.png
     
    • Friendly Friendly x 1
  15. Sand Dancer

    Sand Dancer Crazy Cat Lady

    Joined:
    Jan 12, 2013
    Messages:
    6,881
    Ratings:
    +4,535
    Religion:
    Agnostic Buddhist
    • Friendly Friendly x 1
  16. sun rise

    sun rise Śvāna Dharma
    Premium Member

    Joined:
    Apr 28, 2014
    Messages:
    74,443
    Ratings:
    +38,583
    Religion:
    Love/Omnism
    Giving the poor access to decent health care drives up demand. Do you propose throwing the poor under the bus and going back to them suffering and dying early due to lack of adequate medical care?
     
Loading...