Wake up, America! What is it about the pending demise of the traditional medical profession that you don't understand? You may have been attentive enough to notice in the broader sense that as the percentage of American doctors decreases it becomes camouflaged by the increase in foreign doctors practicing here.
If that's not enough of a concern, then why are the American medical schools having a problem recruiting American doctors, the AMA is promoting re-entry programs for physicians in its February 2009 issue of AMA Voice, a Bulletin September 2008 is asking "Where Have All The Doctors Gone?," and why the U.S. Congress, now trying to revamp the health care system, is having to consider what language to publish the new Health Care Legislation in.
Every physician in this country can see how desperate the situation is, but can't seem to do much about it, at least that's obvious to those of us kept out of the committee room conferences where strategies are born. Physicians also see the problems from the inside of the profession and already know the reasons a medical doctor shortage is moving like an avalanche. So, who's doing anything to prevent it, or at least slow it down? But to do that you need to understand the causes.
Open your eyes to these 5 reasons why we have an American physician shortage: It is vividly clear to every medical doctor in order to survive in the medical profession today, must create a series of defenses against the economic, political, and legal-social barriers which are shredding the medical profession. Who in their right mind would want to become a physician, only to understand that for the rest of their career they will be fighting against the divisive tactics of governmental restrictions?
1. The economic barriers:
If you knew that doctor's incomes have dropped almost 10% over the last 10 years and are continuing to drop by all national surveys, that medical practice business expenses have risen steadily over that same period, and governmental medical fee restrictions are to be increased soon as they are each year, would you consider there was a real problem brewing?
And, even worse, there's no halt to the process over the foreseeable future.
When a physician recognizes that high school dropouts are making more income on the Internet and as managers of a fast food restaurant than he is earning after 20 plus years of education, why not get out quick? And, that's not even figuring in their incurring an educational debt of over $200,000 to pay back as soon as they finish medical school.
Might a doctor seriously consider changing to another career? Or, while in college decide that becoming a medical doctor isn't worth the risks, education, and money spent. Why then, do any of them do it anyway? Who knows?
You, may believe that this information is biased, inaccurate, and deliberately misleading. Check it out for yourself and let me know what you find out from any legitimate sources.
2. The political barriers:
Other than having to deal with fee regulations, which no other profession suffers from, the malpractice issue rises up like a monster in the sea. Why would any college student choose to become a medical doctor, expose themselves to devastating medical malpractice litigation over and over throughout their medical career in practice, and possibly wind up losing their medical practice and medical license (often blackballed in their profession)?
The fact that attorneys compose the majority of the legislative bodies in this country should be a clue as to the cause. They vote in or out medical malpractice laws within each state. Only a small minority of states have been able to establish legislation capping the outrageously high jury verdicts handed down for plaintiffs (patients).
California became the first state to suffer from the results of these run-away verdicts in the 1970s. It was the first to establish a cap on the verdicts. You and I know that lawyers will do all they can do to keep their cash cow producing income.
Understand, the cap on jury awards has to do only with that part of the verdicts called "for pain and suffering"----not for the primary segment of the award to cover the injured patient's future medical bills and care.
There is no national consensus as to how to resolve the issue of legitimacy of a malpractice suit. Some states (like Nevada) have a review panel of several individuals who offer an opinion as to whether the case should go to trial or be dropped. The attorneys are not obligated to take the panel's advice.
With the stagnation of protective medical malpractice legislation progress, doctors will continue to live with the high risk if they choose to become a doctor.
3. Medical Malpractice barrier:
For 2 years in the 1970s in California there were no insurance companies who would write medical malpractice policies for doctors at any premium price. Doctors either left to practice in another state (like has happened in Pennsylvania recently), or went "bare" (no insurance).
With no insurance, doctors took on the high risk of loss or their medical practice, bankruptcy, or worse. The doctors responded by forming their own malpractice insurance organizations which have served them well.
Nevada physicians, especially high risk specialties such a Obstetrics, has recently faced the same problem of unaffordable medical malpractice insurance premiums---and the state still hasn't learned the lesson. Large numbers of Obstetricians left the state leaving patients without care and forcing them to drive out of state to get care.
It's a repeated scenario. No cap on the jury verdicts (the cause)-malpractice insurance companies skyrocket their premiums-doctors can't afford to pay premiums-doctors leave the state to practice elsewhere-patients lose their doctors and doctors become scarce.
Any physician, no matter what kind of specialty they practice, has to learn to live with the risk of a medical malpractice suit.
Also know, doctors live daily with the possibility that any patient can file a medical malpractice suit against them anytime, even years after the event. Even then, the physician becomes "labeled" whether they are guilty of malpractice or not. Further, the mental anguish of court investigation and trial takes a permanent and huge toll on the doctor-win or lose.
Would you be willing to work every day under that threat? Retiring early, changing professions, moving to medical administrative jobs, and trimming medical practices to low risk patients is what is going on now in the medical profession. The prediction is that it will get much worse in the near future.
4. Legal barriers:
Medical licensure has become a political toy. Medical Boards are normally composed of physicians along with a few non-physicians appointed by the state governor. Members often have conflicts of interest which reflect on their management of physicians who are brought before the board.
So it's an arcane topic in most circles. When a physician is reprimanded or punished by the medical board, the action is spread throughout the country to all other medical boards.
If punishment of renegade physicians is not harsh enough, pressure is put on the board to be tougher-or else. Any black mark placed against a physician follows him or her wherever they go to practice. Simply another reason to quit the profession when the board is unduly unfair.
An example of unfairness by a medical board: An experienced and respected physician, board certified, 15 years in practice with a clean record was brought before the board for a legal issue completely outside the medical profession. He was brought before a trial judge, who had just completed her own vicious divorce from a physician husband in the same specialty as the doctor involved.
She proceeded to disregard any defense issues and wrote a 3 page order to the medical board insisting on putting this doctor back through a residency training program for his specialty among several other practice destroying requirements. The medical board ruled exactly the way she wanted.
The real story of the bad treatment was magnified by the fact that no direct contact was made with the doctor by the board other than a letter. He was never interviewed by any member of the board, as is the standard procedure, nor was he ever permitted a hearing in front of the board to present his own rebuttal, evidence, and defense.
Be aware, this was what was done to a physician of quality for a problem that had nothing to do with his medical practice. And, yes, there is more to the story than this which revolved around poor judgment by the board.
Physicians are often unaware of how other physicians view their actions and judgments. They have to live with that.
5. Social barriers:
Physicians have their own clicks they work with, socialize with, and refer to. It's normal and friendly interaction. However, within that physician community are many areas of quicksand which directly affect their medical practice and income. Offending one doctor can lead to 20 others stopping all referrals to that doctor. Peer review of practice mistakes or blunders which are unintended and accidental can turn a doctor's future practice associations into dead ends.
Normally one would expect a professional to act in a mature professional manner-sometimes they do. Often it is more devious and crude when the battles occur. Physicians are very unforgiving of those others who don't meet their own expertise and ability standards. That's what all doctors have to live with to survive.
These five factors have a profound and direct effect on why the physician population is dwindling. The other factors are less extreme. Face it! Doctors are sick and tired of being stomped on and dragged around by those who seem to believe that doctors aren't practicing up to expected standards. There lies the problem.
Expectations for a profession which yet doesn't understand everything in medicine are beyond reality. Medical practice functions on basic medical principles that constantly must be modified depending on the circumstances, and judgment calls which unintentionally lead them astray.
The bottom line is.........what's going to be done about it.......if anything?
The author, Curt Graham, is a medical doctor, marketer, copywriter, author, speaker who has written extensively over his 35 plus years in active medical practice. He is a published author in Modern Physician, and is credited as an expert author by web article directories and self help websites including selfgrowth.com.
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The author, Curt Graham, is a retired medical doctor who has written extensively on many topics over his 35 plus years in active medical practice as a specialist in OB-GYN. He has been published in Modern Physician, and is credited as an Expert Author by EzineArticles.com directory. Go to his website for more detailed and expanded articles concerning obtaining better health care, among others:
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Please feel free to copy, send, or distribute this article as long as the article is not changed, and the author bio resource box is included with the article as written.
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