An interesting opinion piece in the January 19, 2010 Wall Street Journal talks about the coming shortage of doctors and the cuts in funding for training that is being suggested. The article points out that health care reform will create more demand, we have an aging population requiring more care and many doctors are nearing retirement.
Health-care reform will add an estimated 32 million people to the ranks of the insured, driving them to seek medical attention that in the past they may have avoided due to expense. The aging population will also create much greater demand. The number of seniors who need more medical care is expected to soar to 72 million by 2020—nearly double today’s number.
According to a 2010 report by the Association of American Medical Colleges, the increased demand means that our nation will need an additional 130,000 doctors, both general-practice physicians and specialists, 15 years from now. That’s about 20% more doctors than we have currently.
These are all good points. However, are we thinking out of the box on this one? How many doctors does it take to provide the optimum care to the US population? What type of doctors do we need and where are they most needed? More important, are we setting our need on the current model which has thousands of doctors operating a small business or practicing in small groups? Are we optimizing the use of physicians? Sadly, health care reform did little to address the fundamental structure and reimbursement mechanisms in the health care system, so one wonders if merely throwing more money at the problem and training more doctors is the real answer or at least only part of the real answer.
We need to challenge fee-for service, solo practice and the misguided incentives and lack of coordination that go along with both. It seems to me managing costs and raising quality would be better served with salaried doctors free to attend to their patients with no other distractions in a highly coordinated medical community. Making a good income consistent with ones training, experience and results is a good thing. Making more money by providing more services is not.
Is there any logic in providing the one service that most people are emotionally incapable of buying as a consumer on a fee-for service basis? The bells will go off at the AMA at this idea and the assumption will be lower-income (and no doubt claims of lower quality). Lower income for physicians is not necessarily a result of changing the system, but greater efficiency and higher quality may well be.
Related Articles
- N.J. Horizon Blue Cross Blue Shield to make doctors responsible for preventative health care (nj.com)
- Survey finds health-care reform bad for patients, worse for doctors (scienceblog.com)
QUINNSCOMMENTARY 