Physician shortage expected to balloon to 91,500 in 2020

News outlets report on workforce issues, including the doctor shortage, Medicaid pay cuts and the effects of long work hours on medical residents.

"Nationwide physician shortages are expected to balloon to 62,900 doctors in five years and 91,500 by 2020, according to new Assn. of American Medical Colleges work force projections," American Medical News reports. "That's up more than 50% from previous estimates. AAMC officials attribute the widening gap to increased demands from the aging baby boomer generation and expansion of coverage by 2019 to 32 million uninsured Americans under the health system reform law. … To counter shortages, the AAMC is urging federal officials to lift limits on Medicare funding for residency positions, which have been capped at 100,000 slots since 1997" (Krupa, 10/11).

In a second story, American Medical News reports that 20 states enacted Medicaid pay reductions for physicians in 2010, while also struggling "to cope with strong Medicaid enrollment growth, according to an annual survey of state Medicaid programs. Meanwhile, 11 states, six of which also cut pay in 2010, and the District of Columbia have enacted physician pay cuts for fiscal 2011, which in many states began June 30. But the worst of Medicaid pay cuts may be yet to come" as additional Medicaid funding from the 2009 economic stimulus package dries up. "Some states' Medicaid costs could increase by 25% or more in fiscal 2012" (Trapp, 10/11).

The Los Angeles Times reports on the pros and cons on long work hours for residents. "Heroic working hours have long been a badge of honor for senior physicians — the late cardiovascular surgeon Michael DeBakey often bragged that he slept for only five or six hours per night tops. But critics of the policies have long questioned how all these tired doctors affect patient safety and what chronic fatigue is doing to the lives of medical residents at a critical point in their training. For instance, medical residents working shifts longer than 24 hours are about 16% more likely to get into a car accident during their commute back home from work — a problem those live-in docs never had to face." Two doctors present their opposing opinions on the topic (Borrell, 10/11).

The Miami Herald reports on medical scribes, who "follow the doctors around and enter their notes on patients into electronic medical records." Scribes are "typically pre-med students paid $8 to $10 an hour with no benefits" and "save doctors time and money, enable them to spend more quality minutes with patients, and help them bill more fully for services they provide. Scribes are needed to help doctors navigate the tough transition from paper charts to electronic records, which are supposed to make them more efficient and ensure better care for patients. In return, the scribes get invaluable medical experience and recommendations that enable a high percentage of them to get into medical school… The demand for scribes has expanded as hospitals and the federal government have pushed balky doctors to use EMRs" (Meyer, 10/11).

Meanwhile, The Baltimore Sun reports on doctors who are experimenting with social media by offering discounts on Groupon and other sites. They're "intrigued by the opportunity to attract new patients who might have no or little insurance for specialty services, and to provide information and services to current patients. Web pages, Facebook pages and Twitter accounts have become a staple of businesses. The newest trend are dealmakers such as Foursquare (a mobile application allowing participants to 'check in' at locations and win small rewards), Scoutmob (e-mails that promise discounts at hot spots in cities such as Washington, though not yet Baltimore) and LivingSocial (a Groupon-like deal site" (Cohn, 10/11).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.