Doctors See Fewer Entering Profession

IBDEditorials' series, "Critical Condition" ,  looks at the efects of health care reform on the medical profession.  According to the physicians who answered the survey, we're headed towards a critical shortage of doctors.

Readers alarmed to learn in the first part of this series that nearly half of doctors would consider quitting if the government's health care overhaul goes through won't find much solace in another finding — that most of them also expect fewer people to go into their profession.

By better than a 3-to-1 margin, practicing physicians responding to a new IBD/TIPP Poll said they expect fewer students to apply for medical school in the future if Congress' plan passes.

The exact breakdown was 67% to 22%, with 11% not responding. That was the widest margin of response to questions asked in a survey that was mailed to 25, 600 physicians on Aug. 28 and to which 1,376 responded by Sept. 15. Doctors' names were purchased from a list broker.

Combined with the 45% who said they would consider leaving their practice or taking an early retirement, it's small wonder that 71% do not buy proponents' claim that the government can cover 47 million more people with better care and lower cost…

…Doctors' loss of control over how they practice medicine, the advent of rationing and lack of tort reform could have a big impact on the next generation of doctors, some worry.

"(This) plan will result in a rapid and steep decline in the number and quality of physician trainees … an influx of inferior, foreign-trained physicians and a shift toward lesser trained 'physician extenders,'" asserted one doctor….

…In 2006, the full-time physicians who worked in the U.S. numbered 680,500, not counting residents. Based on current population trends, demand for doctors is expected to grow 34% by 2025 to 909,300 physicians.

The AAMC estimates the "most plausible supply" of doctors at 750,000 by 2025 — leaving a significant shortage of 159,000.

Take just one vital part of the practice of medicine — primary care, or patients' first point of consultation. In 2002, 5,746 medical school graduates opted to be primary care physicians. By 2007, just 4,210 did — a 27% decline….

…Shortages will hit the working poor hardest. Some 20% of Americans, 64 million of us, live in rural or inner-city areas that already suffer from shortages. It will only get worse — even with universal care, which proponents argue will help the poor most.

Once it begins, a shortage of doctors is hard to turn around. It takes an average of 10 years for a person to go through medical training, so anything that's done today to boost the number of physicians will take years to have an impact.

And responses to the IBD/TIPP Poll indicate that the overhaul proposed in Congress will make the situation worse.

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