The following is Part 3 of our in-depth analysis of the supply, demand, aggregation and distribution of physicians throughout the United States. Now that we know and understand the magnitude of the shortage of physicians across the U.S., the question becomes “what should we do about it?” The answer lies in a combination of increasing the supply of physicians, bending the demand curve, and the long-overdue retooling of the physician practice.
Increasing Physician Supply:
H.R.2124/S.1148 - Resident Physician Shortage Reduction Act of 2015
Since 1997, Congress has capped the number of Medicare-supported residency slots. In 2015, both the House and Senate drafted bills proposing to add 15,000 Medicare-supported residency positions over five years. Medicare is the largest public supporter of GME funding and Medicare’s Direct GME payments are intended to represent Medicare’s “share” of the training costs for about 80,000 residencies nationwide. While the House and Senate bills to lift the GME cap differ in a few details, both call for expanding residency positions by 3,000 slots per year from 2017 to 2021.
At least half of the additional slots must be used for residencies in physician shortage specialties, to be identified by the National Health Care Workforce Commission. The bills also require a Government Accountability Office study on ways to increase health professional workforce diversity.
The Senate bill prioritizes hospitals that have exceeded their resident cap. The House version includes hospitals in states with the largest populations in Health Professional Shortage Areas. Both bills limit the increased number of slots a hospital may receive.
Both Bills have been in Sub-Committee since 2015.
Bending the Demand Curve
While we continue to innovate in genetics, pharmaceuticals, and medical procedures, bending the demand curve for physician services will ultimately rely on successfully engaging patients in their own care.
Studies have shown that the combination of healthy eating, not smoking, and regular exercise can reduce the risk of heart disease by 80 percent and can reduce the risk of stroke and some cancers by 70 percent. Yet, implementing this into daily lifestyle remains elusive for the majority of the population. Despite widespread messaging about the dangers of smoking, excessive alcohol consumption, poor diet, and lack of exercise, many consumers continue to engage in risky behaviors. The implications include an increase in diabetes and other chronic diseases, with corresponding increases in premature deaths (see below).
Retooling the Physician Practice
Most physician practices operate today similar to how they did in the 1950s and 60s – customers must convince a gatekeeper (receptionist) that they need to be seen, the customer is offered options that best suit the business, time in the waiting room is only exceeded by time in the exam room, and good-paying new customers must go to the back of the line!
Ultimately, physician practices will need to do more with less. This requires customizing the practice model in order to increase the patient panel size of each provider and transition the role of the physician to team and intellectual leader. The modern-day practice will have a combination of the following offerings:
- Team-based care
- Caring providers and staff
- Real-time patient access/Greater convenience
- Online scheduling
- After hours availability
- Minimal wait times
- Empowered non-physician providers
- Clear cost of service
- Access to medical records and digital service
This is part 3 of a 3-part series and reflects the requisite solutions for beginning to deal with the physician shortages across the country. Our next post will allow you download the full study.
If you have any questions or comments, please contact Shane Foreman at firstname.lastname@example.org or 312-423-2671.
If you would like 3d Health to speak to your organization about the shortage of physicians, please contact Shane Foreman or Brittany Foreman.
Sources: AAMC Reporter: June 2015, “Engaging Consumers to Manage Health Care Demand” By Sundiatu Dixon-Fyle, PhD; and Thomas Kowallik, PhD