Nationwide Shortage of Doctors Expected
A homeland security problem… or not?
As the boomer generation ages, there is growing concern there won’t be enough doctors to meet their developing medical needs. As more and more people qualify for and transition to Medicare coverage and national insurance, the physician shortage could get worse and worse.
Could this potential shortage become a Homeland Security issue? Most doctor shortage forecasts assume a typical primary care physician can handle about 2,500 patients each year. Taking that figure as the standard, experts agree there will be too few doctors to meet the nation’s medical needs in the coming future.
For example, in a study released recently by the Association of America Medical Colleges, projections indicate the nation will face a shortage of between 46,000–90,000 physicians by 2025. However, several new developments might change this dire situation.
Dr. Linda Green, a Columbia University mathematician who has spent two decades studying the health care system, modeled two situations while taking into account the increased demand expected to come from insurance expansion and increasing numbers of aging Americans. In her study, she identified two new trends.
First, doctors are merging their practices into larger operations in a trend being called “physician pooling.” Using this new approach, doctors share support staff and office space thereby making it easier for them to serve a larger patient population more efficiently.
Further, the heath care support workforce is evolving as physician assistants (PA’s) and nurse practitioners (NP’s) take on broader roles under the supervision of trained doctors. PA’s and NP’s are medical professionals who, through specialized training, are able to perform much of the same duties as fully-qualified physicians without having the burden of attending medical school. These medical professionals exercise their training under the indirect supervision and review of physicians who are quickly available to address questions and concerns, should they arise. Having non-physician experts like these taking care of routine doctor office visits (i.e., sore throats, ear aches and minor injuries) can dramatically increase physicians’ ability to attend to more-serious patients in doctors’ offices.
Dr. Green suggests that, by focusing on the team approach and increasing the supply of non-doctor experts like PA’s and NP’s, the looming national doctor shortage may disappear as physicians could be able to cover twice as many patients as they do now.
Disaster Response Abilities
Having enough doctors to provide care for the nation’s elderly and their chronic health problems is vital. But, during a natural disaster such as a tornado or earthquake, immediate emergency medical assistance becomes paramount as the need for acute care greatly increases.
During the first 72 hours of a disaster, the primary focus of emergency responders and the healthcare system is on “lifesaving” activities — finding disaster victims and attending to their injuries. In many cases, these injuries suffered can be adequately attended to by PA’s and other non-doctor professionals. Thus, the emerging pattern of “pooling” may also increase the nation’s ability to provide a satisfactory, short-term supply of medical specialists capable of responding to a localized disaster.
Also, specialized disaster medical teams typically deploy to disaster locations, immediately augmenting local resources. This deployment ability does not solve the day-to-day medical needs of a community, but is an efficient model for temporarily boosting a traumatized community urgently in need of medical care. Having a greater number of PA’s, NP’s, and other non-physician professionals available could boost the nation’s ability to quickly tend to mass casualty emergencies.
So, while the jury is still be out about whether the nation may or may not suffer a physician shortage over the next decade, we can be assured that this emergent situation should not become a Homeland Security problem any time soon.
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