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Doctor shortage on the horizon

A physician assistant of family medicine wears a stethoscope.

KAI RYSSDAL: The Association of American Medical Colleges says we're going to need more doctors — 30 percent more in the next 10 years as the baby boomers get older and need more care. But, Helen Palmer reports from the Marketplace Health Desk at WGBH, training more doctors might not be the best way to spend our health care cash.


HELEN PALMER: A survey by the Association of American Medical Colleges found that nearly half of medical schools had already expanded enrollment or would do so soon. But that may not be enough to fill the doctor supply gap. Young doctors' specialist training in hospitals is mostly supported by Medicare. David Goodman of Dartmouth Medical School:
DAVID GOODMAN: Over $10 billion a year comes from Medicare. In order for there to be an actual increase in the output of physicians there would need to be very substantial increases in Medicare spending.

The AAMC wants Medicare to life the cap on the number of trainee doctors it pays for. Goodman points out that the hospital part of Medicare's expected to be insolvent in a dozen years. But quite apart from the financial squeeze on the doctor supply, Goodman says research shows more doctors doesn't equal better care.

GOODMAN: . . . Places where there are a lot more physicians, the costs are much higher.

Costs are higher because people have more procedures. But health outcomes are often worse. Critics also claim we don't train the right kinds of doctors or get them to the right places. Robert Bowman directs rural health education and research at Nebraska Medical Center.

ROBERT BOWMAN: There's a whole bunch of doctors on K Street, and then beyond that other urban areas in Washington DC are hurting for doctors and hurting for health access.

Bowman says elite schools in the big medical centers choose the best and brightest students. They train there, then stay and practice there. He thinks we need to train more primary care doctors from different backgrounds who'll focus on patients with greater needs. The AAMC says it will announce its plans to boost the supply of physicians next week.

In Boston, I'm Helen Palmer for Marketplace.

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