The Looming Doctor Shortage

During the battle to enact the Affordable Care Act, then-President Obama assured Americans, “If you like your doctor, you can keep your doctor.” It’s debatable whether he kept that promise, but changes in the medical profession may conspire to take away your doctor and limit your future choices.

Medical school was once touted as a golden ticket to financial success and professional satisfaction — you’re saving lives, after all. But, have things changed in recent years?

Listening to what doctors have to say these days is instructive. A recent survey found nine out of ten physicians were unwilling to recommend health care as a profession. We all realize the practice of medicine is a stressful endeavor, but according to doctors who were polled, 47% had high emotional exhaustion, 35% saw less value in their work and 41% were satisfied (not happy, mind you) with their work-life balance. That’s quite an emotional burden to bear, and based on the poll, the feelings are systemic.

From the survey, three major themes emerged that contributed to the doctors’ lack of happiness in their jobs: mental exhaustion, loss of autonomy, and asymmetrical rewards. Mental exhaustion was reported as a side effect of heavy workloads and the increased clerical work that accompanies electronic medical records. Most doctors today don’t operate their own practice, but instead work for hospital-owned practices, which curtail control over the hours they work. Furthermore, doctors are held (and must be held) to a high standard of performance. We expect them to get it right every time, and when a physician makes a mistake the result can spell the end of his career. All of these factors attribute to high rates of burnout among medical professionals.

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Consider becoming a doctor from an alternative lens; if we bring an investment/return analysis into focus, the result is still troubling. With the ballooning costs of education over the years, the average bill for four years of medical school at a private institution is now $278,000.  Public schools come in just $70,000 less at $208,000 for the program. Couple this with any student loan accumulated during undergraduate study, and you could easily be staring at $500,000 worth of education debt.

The buck doesn’t stop there. Remember internship, residency and fellowship requirements. All total, doctors in training will bring in about $60,000 a year for 3-8 years. During these training phases, physicians work about 80 hours a week, which translates to around $14 an hour. Wow.

While medical school admissions are still up, more and more students are opting out of the residency requirement to be a practicing doctor. These graduates are choosing instead to go into business, research or consulting roles. Those that do complete the residency are stepping into more specialized forms of medicine, which allow for more freedom and less demand think no emergency or hospital medicine.

It’s no surprise then that folks are worried about the number of doctors that will be practicing as time goes on. This worry appears to be founded. Fewer people are going into medicine to be general practitioners or hospital physicians. And that could translate into fewer choices and longer waits when you seek medical care.

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