Do we have a shortage of medical doctors in America?

A friend of mine told me that the AMA intentionally limits the number of seats in US medical schools to keep physician salaries artificially high. I don't know whether that is true or not. But recently my primary care doctor referred me to a specialist for advanced treatment. When I called to schedule the receptionist remarked that the earliest available appointment was 4 weeks out. That prompted me to wonder if there is a shortage of doctors in America? It just doesn't seem right that I should have to wait 4 weeks to see a specialist in arguably the wealthiest and most advanced nation on earth. Strange.

 

Just try getting in to see a derm. Many of the appointments are up to several months out.

Agree that the number of physicians is being somewhat artificially limited by organizations like the AMA..... but physician numbers are also being very realistically limited by the massive cost and length of MD/DO education and training.

 

For as much money that Americans spend on healthcare in American (about $1 out of every $5 dollars spent in the US economy) there should be zero shortage of physicians and people should not have to wait a month or more to see a specialist. I have spoken with immigrants who have lived in socialized western europe where much less is spent, per capita, for healthcare than in America and their satifaction levels were much higher with the european medical systems. I think the AMA does manipulate the enrollment in medical schools to keep the ratio of physicians to the overall population articificially low. I have read articles on it. I think we are being ripped off by the medical system. That industry operates by a completely different set of rules than all other industries. There is no free market, especially now that people are forced by the government to obtain health insurance. Now we are forced to finance treatment for illegal foreigners who shouldn't even be here in the first place. Go to Mexico and try to get free medical treatment. Down there if you can't pay you go to jail.

 

Thanks for asking, Dr. Dave. I think you will agree that the Mises Institute is a pretty reliable information source. Mises supports its positions with credible public data. So it's a good place to start. However, there are literally hundreds of articles on this subject matter. You can pick and choose at will. But I believe Mises is a good primer.

"To start with, the American Medical Association (AMA) has had a government-granted monopoly on the healthcare system for over 100 years. It has intentionally restricted the number of doctors allowed to practice medicine so as to raise physician incomes artificially. The primary way it does this is by using the coercive power of the state to restrict the number of approved medical schools in operation. After the AMA created its Council on Medical Education in 1904, state medical boards complied with the AMA's recommendation to close down medical schools."

http://mises.org/library/myth-free-market-healthcare

The bottom line is that for as much money as America spends on healthcare ($1 of every $5 consumer dollars) the quality should be MUCH better than what it is. As Mises explains - there is no 'free market' in the US medical industry. It's a massive consumer ripoff. And the linked article was authored in 2011, prior to the enactment of ObamaCare which now forces people to purchase health insurance and limits the insurance policies available. So it's become worse, not better. And it was bad before. The medical industry in America is awful when compared to medical care in other 1st world nations. In Europe they pay much less and produce much better outcomes. Go figure. At some point we must face the truth. We suck.

 

Dr. Dave, all you need to do is research how many new med schools have opened up in the last 15 years, how many new students graduated from med schools and went on to become docs, and whether the % increase in the new grads kept up with the increase in th rate of population growth during that period of time. I think you will find, as pointed out in the Mises article, that the number of med school grads has trailed the growth in the country's population by a long shot. The AMA talks a good game. You have to pull the curtain back and determine whether their actions match their words. I say it doesn't. Look, the AMA is nothing more than a political lobbying group. And they are going to lobby the politicians to promote continued growth in physician salaries. That's what they do. And that is done by keeping supply low and keeping demand high. Like I said, I had to wait over 4 weeks to see a specialist. And I have decent insurance. If the market were in balance that would NEVER happen, sir. And it's not just me. Many friends and acquaintances have run into the same problem. Oh, and don't forget about the AMA's push for Congress to approve ObamaCare. Do your research and look at the exponential increase in AMA lobbyist contributions to Congress from 2009 until ObamaCare was passed. As a matter of fact, the AMA helped to write ObamaCare. The politicians didn't write it! lol. They didn't even know what was in it until after they approved it! lol. They just followed the lead of the lobbyist money!!! lol. The US healthcare system sucks, Dr. Dave. Especially considering that $1 of every $5 consumer dollars gets spent on healthcare in the US. The healthcare industry operates like a drug cartel!!! lol.

 

Thanks for your response, Dr. Dave. Just one more comment w/regard to the AMA. As I previously stated, the AMA supported ObamaCare and contributed LOTS of donations to Congress to secure passage of ACA. You can easily find the level of heightened political contributions on-line with a google search. From 2009 to ACA enactment the AMA contributions went viral in support of ACA. And the AMA knew FULL WELL that it would add 35 million or more new enrollees to the healthcare rolls. And the AMA also knew that it would create MUCH more demand while the rate of growth of new physicians remained stagnant. NOW, as I type, most news agencies are reporting that there has been a sharp increase in wait times to see physicians (both primary care and specialist) with the inception of ObamaCare. CNN has many articles about this. So while physician shortages in America were a problem prior to ACA, now the problem is even getting worse. Physicians are smart people. You can't convince me that the AMA didn't have a clue of what to expect when 35 million or more additional health care lives were dumped on a physician population that has shown virtually no growth for the last 15 years. I give medical doctors much more credit than that. They certainly knew what outcome to expect. More work. Bigger incomes. It's that simple. Thanks for the discussion.

 

Here's a WorldBank chart of Physician to Population ratios showing # of physicians per 1000 residents. The USA has about 2.5 doctors for every 1000 residents. All the 1st world industrialized nations show between 3.2 and 4.0. Why does the USA have a lower ratio considering that we spend considerably more of our GDP ($1 of every $5 consumer dollars on medical care) than those other 1st world nations ($1 in $8 consumer dollars on medical care)? So we Americans spend more and get less. That doesn't seem fair.

http://data.worldbank.org/indicator/SH.MED.PHYS.ZS

 

In The Atlantic article linked below it illustrates the onerous hoops of fire that foreign medical doctors must jump through in order to begin a practice in the US. The rules and regulations authored by the AMA are much more restrictive than the eligibility requirements found in other 1st world nations. Trust me, I am in favor of giving healthcare jobs in the US to US trained medical doctors. However, it is estimated that the US will face a shortage of over 91,000 physicians by year 2020 (see article). And nothing is being done NOW by the AMA to increase the population of US physicians to avert a national crisis come 2020. The AMA is simply not creating enough seats in our medical schools, nor are they promoting greater opportunity for more residencies to avert a huge physician shortage. To top it off, the AMA makes it so difficult for foreign trained physicians to qualify for a license that most refuse to even apply. So it appears to me that the AMA is part of the problem, not part of the solution. It appears to me that the AMA is doing it's darndest to help create a physician shortage, not prevent it. There is no reason to face such a drastic shortage of qualified medical doctors in a nation that spends $1 of over $5 consumer dollars on healthcare. And when you compare the number of physicians per 1000 population in the US with the same per capita measurement in other 1st world nations (see previously linked data) it obvious that something in America has run amok.

http://www.theatlantic.com/health/archive/2014/11/doctors-with-borders-how-the-us-shuts-out-foreign-physicians/382723/

 

You make all good points, Dr. Dave. And yes, I think we do agree on most of them. If 25% of physicians practicing medicine in the US are foreign trained it's absurd. It just increases the cost of a medical education here. And it's not fair to the qualified American kids who are rejected by US medical schools due to the insanely rigorous academic requirements. More money should be spent on US residency programs and increasing the number of seats in our medical schools. Besides, many of these foreign trained docs come from India, Pakistan, Iran, etc....where there is a shortage of physicians to treat their own populations. Plus, those foreign doctors are probably trained at 25% of the cost of what it takes to train a student in a US medical school. The kids coming out of US medical schools have likely accrued $350,000 in student debt. That's not easy to pay off, especially for those who practice general medicine. There is incredible mismanagement of the US healthcare system. I have no idea why a bright young kid would choose medicine as a career these days. And I had a completely opposite opinion 20 years ago. Thank you for the insightful discussion.