Wednesday, January 18, 2012

Too few doctors

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The onslaught has begun.

The Pew Research Center reports that every day for the next 18 years, 10,000 people a day will reach the current age of retirement and eligibility for enrollment in Medicare. Every day, the same people will begin moving into their highest health-care consumption years.

At the same time baby boomers are aging, so is the medical profession. About 40 percent of the nation's doctors are 55 or older. In Idaho, 21 percent of doctors are over 65, and about a third of America's nurses are 50 or older. These numbers lead to an inevitable shortage of 65,000 physicians by the year 2015, only three years from now, and 125,000 doctors by 2025.

It would be great to think we could just announce we want more doctors and have them appear. It would be nice to think we could just shift some of the tasks to other highly trained professionals about whom MD's have been suspicious in the past.

Realistically, it will take years to train enough young doctors to replace those retiring, much less add capacity to serve the exploding patient population. It will take time to develop the patient awareness and medical-care delivery systems to fully utilize nurse practitioners and physician assistants.

Unfortunately, at the very time we need to be training physicians and physician assistants and nurses and nurse practitioners, Congress and state legislatures, in the current slash-and-burn budgeting climate, are heading in the opposite direction. Medical schools are under significant financial pressure. For many, the only solution to shrinking budgets is to shrink class sizes.

We need doctors to train doctors at exactly the moment we have fewer doctors and want to spend less on them!

Solutions in the massive economic segment called health care will not be simple, much less immediate. Although money is not the only element of those solutions, an important step will involve government help for medical education, as has been done for years. But money won't be enough.

The medical community will have to accept new players in new roles using new technology. Boomers and younger will have to accept some responsibility for their own health. For instance, type 2 diabetes, according to one major researcher, would be largely wiped out by eating right and exercising to lower body fat.

Decent health care is the right of every citizen, but it will require every citizen to play a role in finding healthy solutions.

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