Thoughts On Solving The Looming Primary Care Doctor Shortage

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The physician shortage is real. How do we know? A study conducted by the Association of American Medical Colleges (AAMC) found that by 2025, the U.S. could be short as many as 94,000 physicians, with as many as 35,600 serving as primary care practitioners. The study cited an aging population as a big reason for the shortage; most physicians are now over the age of 55, and a large chunk of the population as a whole is getting older, which means they’re getting sick more often and need more care.

It seems like a simple problem, right? Encourage more young people to become doctors! But that theory comes with too many roadblocks. Medical school is expensive and it takes a long time. Not to mention, the system is plagued by bureaucracy and obstinacy; it’s only set up to support a certain amount of physicians each year.

The federal government hands out subsidies to hospitals for residency programs based on outdated figures, with only enough money to cover the amount of physicians needed over 20 years ago. Obviously, a new approach and new thinking is a requisite for solving this problem.

1. Giving More Autonomy to PAs and NPs

Physician assistants and nurse practitioners

are some of the most under-utilized resources when it comes to the primary care shortage. These professionals can do many of the same jobs as physicians can – prescribe medication, perform routine exams and make diagnoses – but, in many places, they’re not allowed to practice without the supervision of a physician. Nurse practitioners currently have full practice autonomy (meaning they can start their own practices) in just 22 states, while physician assistants must be supervised by a physician in every state.

2. Deploying Doctor Drones in Rural Areas

As you probably know, some of the biggest challenges of the doctor shortage come into play in rural areas. To combat this issue, a pathology professor at Johns Hopkins named Timothy Amukele developed a high-flying, blood-carrying drone that could fly essential blood and medications into extremely remote regions. We’re not suggesting robots as a viable replacement for medical professionals – no, we’ll always require flesh and blood medical pros who wear scrubs and give personalized care – but it might be a good way to improve preventative care.

3. Reforming Education from the Ground Up

If you want to see just how far medical professionals will go to make the point that med school needs major reform, just take a look at the Ponce Health Sciences University in Ponce, Puerto Rico. An organization called Tiber Health built the new med school as an experiment to address two of the things its founders believe med schools get wrong: they accept students based on the wrong factors, and they spend too much time and money on lectures and not enough on practical, hands-on lessons. With this new method, the founders believe they can train doctors more efficiently and more affordably, which would certainly help address the shortage.

4. Embracing Diversity

The U.S. doesn’t just need more doctors, it needs more Hispanic and African-American doctors. According to the AAMC, med school graduates are overwhelmingly white (58.8 percent) and Asian (19.8 percent). Recruiting physicians from minority populations can help solve the doctor shortage in several ways. For one, underrepresented minorities are more likely to go back and serve in their communities, so they’ll provide aid in traditionally underserved areas. Plus, black doctors are more likely to work in primary care than specialty care, so they could help to curb the shortage.

5. Building Smart Homes for Older Adults

In a recent talk about how technology can be used to address the problem of the healthcare workforce, California Health Care Foundation (CHCF) President and CEO Sandra Hernández said that building care-centric structures – she means physical structures, like houses and nursing homes – will help address the issue by lowering the amount of care required. These buildings, say Hernández, should be equipped with monitors to detect falls, alerts that remind residents to eat and voice-activated devices that connect the elderly to doctors, nurses and family.

6. Getting Used to Artificial Intelligence

Again, we’re not suggesting that physicians could be totally replaced by robots, but there is definitely a benefit to embracing new technology. It’s particularly promising with regard to artificial intelligence (AI), with a number of applications that could directly combat the shortage.

For example, AI systems may soon be used to analyze patients’ X-rays, MRIs and CT scans, jobs that are notoriously time-consuming for human workers. Coupled with machine learning, AI could even interpret large sets of data and use algorithms to design drugs. With this strategy, the goal is to make the job itself more efficient and less demanding so that it requires fewer physicians. In other words, it helps to cut the amount of work to match the number of doctors.

7. Letting Tech Handle Scheduling

Like AI, this idea is based on the approach of rebalancing demand and physician availability. In other words, it helps make a doctor’s limited amount of time go further. Using scheduling software, doctors are able to increase capacity by filling empty appointments and reducing no-shows. For example, a patient who needs to get into see the doctor within a few days may not be able to schedule an appoint for another week or two, but an automated scheduling system could easily alert that patient if another patient cancels and an appointment becomes available.

8. Implementing Digital Health Solutions

Don’t throw away your stethoscope just yet! Real-life doctors, not computers, will always be vital to healthcare. Even though, no matter how you slice it, the U.S. needs more doctors, there are a few ways health systems are using technology to reach underserved communities. For example, while there are thousands of working physicians in a certain metropolitan area, there may be only one or two serving a sparse or rural population. With telehealth initiatives and web-based care (and innovative tools like medical drones), doctors can provide quality treatment to patients anywhere in the world.

Final Thoughts

While the primary care doctor shortage is concerning, there are plenty of solutions on the horizon that can help manage the situation. It’s all about planning for the future and creating innovative solutions.

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Deborah Swanson is a Coordinator for the Real Caregivers Program at allheart.com. A site dedicated to celebrating medical professionals and their journeys. She keeps busy interviewing caregivers and writing about them and loves gardening.
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