Fig 1. Heroic Stories. The Amazing Doctor.
With all the hang-ups in administering care to the public, one of the biggest setbacks might be the fact that we simply don’t have enough physicians. With the years of training required to enter the field of medicine and a growing price tag that comes along with the education needed, less people are pursuing the long-honored profession. This is a problem especially when looking back at some of the past articles we’ve read in Hall on Health. With unhealthiness trending in the forms of rising obesity rates, hospital-associated infections still tallying large numbers in deaths, an ever-growing aging population of Baby Boomers, and with millions of new beneficiaries under the Affordable Care Act, we need physicians now more than ever.
“The cost is too great, and it’s a lousy job,” said Regnal Jones, executive director of the Chicago Area Health and Medical Careers Program. “The minute you say to me that you want to be a physician, it’s tantamount to saying you want to be an indentured servant.”
Jones was fielding questions from Dawn Trice, a Chicago Tribune reporter. In 2013, Trice took to speak with Jones upon hearing word of his then-unorthodox advice. For years Jones had preached and encouraged the medical school route to his students from underrepresented racial and socioeconomic groups. Having helped nearly 5,000 students at the time of the interview, Jones had helped many along the way to medical school admittance. However, over time his view of that decision had changed.
Fig 2. New York Times Blogs. Should Medical School Last Just 3 Years?.
Many have begun to think this way as well, and for the same reasons. Jones goes on in the article to highlight the years of commitment required through schooling, the nearly insurmountable debt that accompanies it, and the grueling hours required during lengthy residencies that only net you as little as $40,000 a year.
For these reasons, many would-be physicians are turning to the physician assistant track. Physician assistants, or PAs, are growing in demand—both by health care systems who see them as cheap alternatives to physicians and future health professionals. The allure of the position lies in the time commitment to training, the liberties of the position, and the opening salaries.
To become a physician assistant, significantly less time is required when compared to the schooling a physician must do. Following your undergraduate years and a entry exam, students typically complete an accredited Physician Assistant program, which is usually only a 25 month process. While this is 2 years, it is still only half that of a med school program. Once this program is completed, PAs must successfully finish a year-long clinical rotation, giving them experience in the field. From there, they are free to practice as fully trained physician assistants (with the caveat of regular re-testing and continued education throughout their career).
Fig 3. Hartford Courant. Quinnipiac Physician Assistant Students Volunteer Time, Skills As Urban Health Scholars.
The liberties of the profession are fairly numerous. While a PA operates beneath a physician’s supervision, they are able to perform many of the same duties: examinations, diagnostics, developing treatment plans, counseling patients, and—in some states—writing prescriptions.
Compared to the entry-level salary of doctors at $40,000, a PA’s average salary out the gate falls around $90,000. This stark contrast is something that entices many to the position. While there is a about a $100,000 disparity between the average salaries of the two positions ($201k for physicians vs. $102k for PAs), many argue that the time spent in the workforce before physicians are fully practicing makes up for it. With less schooling debt and not as much need for heavy malpractice insurance due to lower liability, the salary of a physician assistant comes with less catches.
For this reason and many others, there is a growing shortage of doctors in the United States. The Association of American Medical Colleges (AAMC) calculates that the United States will have a shortage of between 40,800 and 104,900 physicians by the year 2030. The study run by the AAMC uncovered that the numbers of new primary care physicians and medical specialists aren’t tracking with the increasing volume of the growing and aging US population. Like mentioned before, the study also calls on America’s growing aging population as the primary stressor and concern. The article published calls to attention that by 2030 the 65 and older population is expected to increase by 55% and the 75 and older population by 73%. The CEO and President of the AAMC, Darrel G. Kirch, MD is quoted saying, “This makes the projected shortage especially troubling, since as patients get older they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe”.
Fig 4. Medical Recruiting. Part- Time Physician | Post Injury Care| Salt Lake City, UT.
This is an issue that is perhaps greater than any covered before in these posts. Without physicians, we will be hard-pressed to even treat anything you’ve read here. The AAMC advocates a multifaceted solution that covers healthcare delivery innovations, team-based and coordinated care, and a better use of technology. The association is also pushing hard for increased federal support of residency positions in the US. It states that, while many medical schools have expanded their class sizes, there are still not enough openings in graduate medical education. By proposing an additional 3,000 spots in residency over a 5-year span, more doctors will be practicing in the field and lending their services to people and the country.