July 21, 2010
5:23 pm
Yesterday, the Arkansas surgeon general told a state legislative committee that the state’s physician shortage would be worsening once health reform is implemented. Dr. Joe Thompson testified that 80 to 90 percent of Arkansas’ 500,000 uninsured residents will become newly insured, most of them through an expansion of the Medicaid program. He emphasized that the state already has severe doctor shortages in its rural areas.
At the same time, Physicians News Digest is quoting a report by the New Jersey Council of Teaching Hospitals which projects that New Jersey will have a shortage of approximately 2,800 physicians (and as many as 3,250) by the year 2020. In New Jersey, health reform will add roughly 1.3 million patients to the newly-insured rolls. The Council projects severe shortages in primary care as well as neurosurgery and pediatric subspecialties.
We’re going to be hearing more warnings like these, most likely from every state. There’s no debating that addressing the uninsured problem in America is a good and necessary thing. But, we can’t be complacent in believing that expanded coverage necessarily leads to expanded access. It’s quite clear that our rapid increase in covered individuals is going to outpace the supply of physicians, nurses and other healthcare professionals able to provide care. As policymakers revisit health reform, which it inevitably will, addressing these shortages has to be an urgent priority.
July 15, 2010
3:32 pm
Two news stories this week raise serious concerns about the effectiveness of systems intended to act upon physicians and nurses who don’t meet adequate standards for providing patient care.
• A Massachusetts General Hospital survey of more than 3,000 physicians across multiple specialties found that one of every three doctors rejected the idea that they should report colleagues who are incompetent or impaired by substance abuse or mental health problems. The survey found that 17 percent of doctors had encountered a physician who was either incompetent or impaired, but only two-thirds of those doctors turned in their colleague.
• In today’s USA Today, it was reported that nurses who have committed acts of misconduct in some states can easily get jobs in other states that are part of a multi-state compact aimed at getting nurses into regions that need them the most. The news article cited a nurse in Wisconsin who was fired for stealing narcotics, but still maintained a clean record in the eyes of the multi-state compact and was able to easily get another nursing job in North Carolina.
I don’t want to oversimplify these issues. Certainly, it is difficult for physicians, in order to maintain open lines of communication and collaboration, to “snitch” on a colleague who has an addiction problem or who may even be suffering early signs of dementia. And, for nurses, the idea of multi-state cooperation is a good one because innovative steps need to be taken to address the nursing shortages that exist in so many parts of the country.
In the end, though, the patient has to come first, and patients can’t be put at risk by any lessening of standards when it comes to the quality of physicians and nurses. There is a need here for associations representing both professions to be proactive in ensuring that all members in their ranks meet the highest standards.
April 27, 2010
1:06 pm
An interesting, and troubling, piece ran recently in the Wall Street Journal. The article highlighted one of the major shortcomings of the newly enacted health reform law. This article, “Medical Schools Can’t Keep Up,” said covering 32 million more people who haven’t had health insurance outpaces the capacity of the number of doctors we have to attend the new total number of patients. As well, the medical education system won’t be able to produce enough new doctors to meet the demand.
Estimates predict a deficit of doctors potentially reaching a 150,000 gap by 2025. The United States currently has 954,000 physicians. The area in which doctors are needed is in primary care. Yet, that’s the practice fewer medical students have been selecting. Medical training programs have begun to push primary care, but the supply pipeline is definitely behind the curve. The new health law only adds to that problem.
Plus, everyone must train in a medical residency program in order to lawfully practice medicine. But residency slots are limited, and the law’s cuts to Medicare, which pays for medical training programs, don’t help.
Unfortunately, all Americans will feel the effects of this physician shortfall. The Journal reported: “A shortage of primary-care and other physicians could mean more-limited access to health care and longer wait times for patients.”
The Wall Street Journal article reminds us that healthcare coverage doesn’t necessarily equal healthcare access and that more work remains to be done to fulfill the vision of healthcare reform.
July 02, 2009
8:05 pm
The media’s wall-to-wall coverage of Michael Jackson unfortunately bumped an important network television report on healthcare, a piece that Americans need to see as we determine the future of our nation’s health system.
Fortunately, journalist John Stossel’s report on the Canadian healthcare system, which is often touted by proponents of a government-run health insurance option, will air on ABC’s 20/20 on Friday, July 17. Based on the preview of the story that Stossel has placed on ABC’s website, he will interview physicians and hospital administrators in Canada regarding the problems of physician shortages and long wait times for treatment that have resulted from having a government-controlled health system. Read more
June 30, 2009
10:28 am
I want to thank WPTF Radio of Raleigh, NC for inviting me on the air yesterday morning to discuss health reform. It was a good opportunity to talk about the possible impact on physicians, hospitals and patients if Medicare payment rates are expanded to cover a significantly larger portion of the population. You can listen to the interview here.
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