One of the major challenges of insuring the millions of US Citizens who don't currently have health coverage will be paying for it, which we discussed earlier this week. Another challenge will be having enough doctors and nurses -- not to mention other patient-facing medical professionals -- to meet demand. A recent WSJ article on the subject captures the challenge best when it notes that "at current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges ... The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient."
The logical -- if you work in government -- solution to the problem is to encourage more people to go into medicine by encouraging larger class sizes and new schools, but I question if this is the right move. After all of these years, scarcity in medicine on the physician level may have been a positive thing. After all, medicine is a field that we only want people of a certain intellect, skill set and capability going into. So rather than dig lower in the barrel of potential MD or DO candidates by increasing the number of spots in existing medical schools and launching new ones, maybe the best thing is to look offshore and consider a global sourcing of physician talent of sorts, waiving the US residency requirement in certain cases.
For those worried about bringing offshore physicians into the US without residency requirements, why not create a new system with lower levels of reimbursement (and greater oversight) for "offshore" physicians coming to the states. For their initial years, these doctors could serve those patients that previously did not have any care at all, while gaining the on-the-job experience that a residency traditionally provides. It's not a perfect solution, but it seems more fair and equitable than taking away care from those who pay for it to reallocate physician time to those relying on the state to fund all or part of their healthcare needs.
- Jason Busch