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Why is the U.S. facing a physician shortage?

Mercy Health

As current physicians get older, a recent trend shows that there aren’t enough potential physicians to replace them. Some projections say that by the end of the decade, there will be a shortfall of 90,000 doctors, causing what many are calling a doctor shortage. What happens when there aren’t enough around?

This week on Take Care, Dr. Atul Grover discusses the causes of the nation’s doctor shortage. Dr. Grover is chief public policy officer of the Association of American Medical Colleges. Trained as a general internist, Dr. Grover now holds faculty appointments at the George Washington University School of Medicine, and the Johns Hopkins University Bloomberg School of Public Health.

Click 'Read More' to hear our interview with Dr. Grover.

Medical school applications are on the rise, so the idea of a doctor shortage may be hard to understand. According to Dr. Grover, the problem is not students getting into medical school, it is students being able to get into a residency training program, which is required in order to become certified in a specialty.

“So the real bottleneck is we have plenty of bright young students interested in a career in medicine, and we’ve made more space for them in U.S. medical schools, but we haven’t grown the number of residency training programs that all doctors need before they go out and practice,” says Dr. Grover.

Credit University of Nottingham / Flickr

These residency training programs can last for a number of years, meaning that entering the medical field is a large investment of both time and money. This is a huge deterrent for potential students, especially because students coming out of medical school are, on average, $160,000 in debt.

“Student debt is a huge issue for our graduating medical students, and it’s certainly something that weighs heavily on their minds as they make decisions about what specialty to practice and where to practice,” says Dr. Grover.

Some experts question whether medical school should take so long, and think shortening training programs might help alleviate the shortage.

Dr. Grover disagrees. “We have an obligation to the public to make sure our physicians are well-trained and able to take care of you, me and our families.”

But some schools are experimenting with shorter programs. “People have different rates of learning, and we’re trying to figure out how we better measure and adapt those rates of learning, but we want to make sure we do it in a way that is fair and best for the patients,” says Dr. Buxton.

Dr. Grover points to the federal Balanced Budget Act of 1997 as the beginning of this problem. “Historically, Medicare would pay for its share of the costs of training physicians since we take care of a lot of Medicare patients in our teaching hospitals and in our medical school faculty plans. But, in 1997, Congress said, ‘We’re not going to pay our share of training anymore physicians that are training right now.’”

Because of this, Dr. Grover believes that, by the end of the decade, there will be more medical school graduates than open residency positions, causing a doctor shortage. He believes that if Medicare resumed paying for its share of the cost of training physicians, more spots would open up.

While this impending issue may discourage some from entering the medical field, Dr. Grover believes that it shouldn’t deter them.

“Medicine is and will continue to be a wonderful, exciting, rewarding career, because you get to take care of people. And I would say if people are interested in medicine, they should go for it. I think of regardless of what changes in the U.S. healthcare system, there will always be a place for people who care for others,” he says.