Thursday, January 23, 2014

Physician Shortage

The health care delivery system in the United States is currently undergoing a transformation. One key element to this transformation is to assure every American has a primary care provider. Primary care providers are increasingly often “mid-level providers,” these include nurses and physician assistants who are often required by law to work under the direction of a licensed physician. Unfortunately, the medical educational system is unprepared to tackle this task. Applications to medical school are the highest they have ever been but medical schools have not increased their capacity until recent federal mandates have been imposed. Another aspect of the physician shortage that has not been addressed is physician burnout. A recent study looked at physician satisfaction at three career stages. Physicians in practice 10 years or less (early career), 11 to 20 years (middle career) and over 21 years (late career). Interestingly, middle career physicians had the lowest satisfaction with their work-life balance and the highest rates of emotional exhaustion and burnout. This group was also most likely to leave the practice of medicine for reasons other than retirement in the next 24 months. It is apparent that the increased demand on physicians must be addressed to preserve and hopefully increase the physician work force. This is a crucial element for health care transformation to be successful.

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