One of the many current myths about healthcare is that “nobody wants to be a doctor” because of the various regulatory and economic restraints in the United States. As a result, some believe, there will be a large deficit of physicians to care for the impending addition of tens of millions of uninsured people. The one thing for certain is that there is a lot of uncertainty surrounding the question. Medscape Today had a very interesting three-minute video by Dr. Eric Topol, author of The Creative Destruction of Medicine, about whether our nation is on the verge of a healthcare provider shortage, or whether clinicians are being phased out by algorithms (Topol, 2013). (Also see Doctor Shortage or Surplus). Another uncertainty is how many uninsured will join the rolls of the insured. The goal of universal healthcare is admirable and important for a wealthy nation, but unfortunately, it appears that it is going to take more time than projected to make it a reality.
Back to the question of physician shortage, are students applying to medical school? Yes, in record numbers. Last year, 48,014 students applied to U.S. medical schools, a 6.1% increase from the previous year. Is it possible that the 20,055 who enrolled care more about taking the Hippocratic Oath, saving lives in the emergency room, and caring for the sick than they do about the politics of the Patient Protection and Affordable Care Act (ACA)? Read the ACA here if you want to know what is in it.
More students enrolled in medical school in 2012-2013 than the previous year despite not being guaranteed a residency position after graduation and the prospect of having enormous debt — $170,000 on average — upon graduation. The medical students take on the debt with no assurance they will be able to earn a sufficient living to pay it off while providing for their families. The real issue is not how many uninsured will get coverage nor whether or not there will be a shortage of physicians. The real issue is whether there will funding for the teaching hospitals of America to provide the residency training that is required before a physician can practice on their own.
There is a long list of things that our Congress legislated but then failed to provide the funding to implement. Medical residency training is one of them. The Balanced Budget Act of 1997 froze funding of graduate medical education at 1996 levels for most teaching hospitals. Teaching hospitals are facing restrictions on their ability to develop or expand new programs, according to the Association of American Medical Colleges (AAMC). The CEO, Darrell Kirch, MD, said that if Congress does not address the funding issue that there could be a serious shortage of physicians across the board.
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