Contributing Factors to the Current Physician Shortage

As early as 2005, predictions were being made of a coming shortage of medical providers for the United States. The reason that was primarily referenced for this coming shortage was a lack of adequate forecasting for an aging baby boomer population as stated here in a 2005 USA Today article:

The country needs to train 3,000 to 10,000 more physicians a year — up from the current 25,000 — to meet the growing medical needs of an aging, wealthy nation, the studies say. Because it takes 10 years to train a doctor, the nation will have a shortage of 85,000 to 200,000 doctors in 2020 unless action is taken soon.

Certainly, there is truth to this idea. I personally get numerous job offers on a weekly, and sometimes daily, basis. But there is something that these studies and articles are missing. A number of doctors are also getting so fed up with medicine that they are choosing non-clinical careers; careers where they don’t do patient care.  This includes working for drug research companies, writing/editing, educating and even leavingmedicine altogether. I read an interesting article on-line by Dr. Kent Bottles in a Physician’s News Digest from 1999 that discussed some of the discontent doctors are feeling these days:

There’s a 1998 survey by Levin of 6000 physicians in 22 different cities that revealed that 46% of all American clinicians often think about leaving clinical practice. That’s over 300,000 physicians in the United States that seem to be unhappy with the state of affairs. There are other indications about physician discontent that you might not think of readily. The number of disability claims by physicians has increased so much that some insurance companies no longer are writing disability insurance for physicians. Recently the AMA, one of the more conservative organizations of physicians, has voted to form a union. And another example I saw was an article that said that physicians are actually moonlighting by selling cleaning products and herbs out of their homes. So, for a lot of statistical reasons and for a lot of those more soft reasons, it looks like physician discontent is widespread and happens throughout the whole country.

I am also personally one of the aforementioned doctors who has thought of doing something else with my life. Medicine has changed so much that it has become unrecognizable to some of the older docs, and it can sometimes be down-right depressing for younger ones like me. Sure, all jobs have the good and the bad right? But to me it seems somewhat different when you dedicate 10 years of your life to learn a skill and then have someone accuse you of intentionally and knowingly trying to harm them.

I posted an article yesterday about how we, as medical practitioners, had misled people regarding the “threat” of Strep throat. I stated that, statistically speaking, the risk of serious side effects from antibiotic use for this condition outweighed the benefit. And in turn, I received comments that reflect what we all unfortunately hear in medicine from time to time. That we “don’t care”, or that we diabolically “want people to suffer”.

To me, this arrow stings the most. That someone would really think that because I make a certain medical decision, that this means that I intentionally wish to harm them or cause them to suffer needlessly. Maybe I’m too young and haven’t yet developed skin thick enough to deflect these barbs. And then again, maybe I never want to develop such thick skin. If I did, then I wouldn’t be able to muster the compassion for other people who do trust us and don’t want to just give us orders.

Overall, I think it is a global phenomenon of lack of manners that has developed. As a doctor, I am humble enough to say that I will not be right all the time, and I don’t have to be. What I am charged with doing though, is not harming my patient. If you are a patient and reading this, please remember one thing. You can always get a second opinion. You don’t have trash someone just because the one snippet you heard on Oprah or read in Time magazine seems to contradict your doctor’s decision or advice.

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10 Responses to Contributing Factors to the Current Physician Shortage

  1. Esther says:

    Interesting thoughts. You’ve described adequately part of the reason I have chosen to pursue a PA and not a MD for right now. I don’t want to do 10 years of schooling and then feel like it was a waste — keep in mind I am returning to school as a non-traditional student. It’s sad that doctors are no longer well respected. I have many conversations with people about their opinion on medicine because of my career goals and they’re often negative.

    I do not understand people who claim that doctors want them to suffer. That’s like reverse narcissism. They think the doctor is so caught up in their personal problems that he is actively thinking about causing them harm? Unlikely. I count myself lucky that my doctor remembers anything about me without rereading my chart (I’m sure he has thousands of patients, how can he remember all of them?).

  2. Nurse K says:

    Have you ever not prescribed antibiotics for strep? I want to be in the room with popcorn the first time I see someone do that.

  3. Jude says:

    I guess i am one of the few who doesn’t feel that all those years are wasted to study and internship residency. Although, sometimes i get the unreasonable patient, who thinks we can do miracles, but i remind myself, i had more of the grateful ones than the other kind….I am not an ER doc either so i guess that helps.

    • ER Doc says:

      Hi Jude – Yes, we sort of do have a skewed population in the ER, but I am glad that you are remaining positive and hope I can continue to stay that way as well.

  4. Erica says:

    Couldn’t agree more on the phenomenon of rampant bad manners. Rather than rant here, though, I’ll post on my own blog. The end result of the misuse of the system that we see in the ER, and the entitled or downright abusive behaviors of a percentage of the patients is just what we all dread: becoming too thick-skinned, too jaded, too cynical to muster that compassion when we ought to. And that’s sad for the normal people out there.

  5. dorian says:

    i just came to say i really enjoy your blog. i work in the other side of health care (veterinary). the patients i work with have more claws than yours, but when you get down deep enough, things seems to equal out.


  6. Scrubs says:

    I know it can be time-consuming to update your blog but thank you for keeping me informed and entertained!

  7. Good information relative to physician recruitment. Thanks for the work on this.

    Russell Podgorski, CIR, PRC

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