Doctors’ Shortage: Why Doctors Are the Main Problem

One of our readers left an interesting comment regarding the medical profession and its desire to seek profits for its members. I quote from his comment:

The nature of the AMA, a protected and virtually untouchable union, certainly believes in maximizing its members’ profits. It clearly restricts the supply (as all unions do) in face of a steadily growing demand, forcing prices high and higher.

This sheds some interesting light on the medical profession. It is often overlooked by consumers that the medical profession is limited in its numbers and doctors themselves are part of the reason there is a shortage of doctors. In particular, the number of physicians trained in the United States is far less than the need for doctors. As a country full of patients, we are bulging at the seams and in need of more doctors.

However, the number of physicians in this country is limited by the number of U.S.-trained physicians as well as the number of foreign medical graduates coming here to finish training and to practice. The physicians’ lobby in Washington ,D.C., is very strong in limiting the expansion of training programs. In some specialties, there is such a shortage of physicians that you have to wait several months in some communities to see a doctor.

An example of this would be the surgical subspecialty of Ear, Nose, and Throat Surgery, also known as Otolargyngology or Head and Neck Surgery. There are only a few hundred training positions available in the United States each year for this specialty. If these specialists were evenly divided up across the country, that would leave only 3 or 4 per state. However, physicians tend to be concentrated along both coasts and the Midwest, leaving huge gaps in many states across the country. Thus, the demand is very high, and the supply is low. Like many other specialties in medicine, the lobby is strong to limit the expansion of residency positions, keeping the supply low.

Thus, inherent in the system is a type of unionization to prevent competition. The profession protects itself and is profit driven. However, this monopolization and protectionism is not unique to medicine. If you look at almost any other industry, you will find that there is intense national protectionism from offshoring and outsourcing in the form of tariffs, tax credits, and favorable legislation. Similary, in the U.S. the medical profession limits the number of physicians and creates arduous licensing and credentialing requirements to limit supply.

3 comments to Doctors’ Shortage: Why Doctors Are the Main Problem

  • alexander lenard, md spine surgeon

    Your assertions are comical. When a primary care doctor can expect to make 80k per year after borrowing 150k and starting his career in his early 30’s, why would he or she do it? Further, throw in the fact that you can sue him him for any reason, whether he was right or wrong, and you have your reason for loss of supply.

  • roxane sanders md

    I agree with dr. lenard. JC likens the control of the numbers of doctors and the arduous credentialing process to limiting supply and price fixing. Becoming and practicing as a physician is expensive hard work, and it should be. The controls are in place to increase quality and competence. Few physicians have influence over the number of training program slots and most of us would welcome a little help with our waiting lists of prospective patients. With rising malpractice rates and declining insurance reimbursement and physician income, there is little evidence for the economic control concept.

  • Bah, humbug! I don’t believe a word. A holier-than-thou attitude on the part of U.S. physicians vying for precious health care dollars is the reason why I, an American citizen, cannot obtain a medical residency in my own country. By keeping the number of residency positions down, discriminating against American citizens trained abroad, and allowing swarms of foreign national physicians to take positions from American citizens, the powers that be are slitting their own throats. Pretty soon foreign national physicians will make a piece of the pie even smaller for those powers. God helps those who help themselves, and foreign interests have helped themselves to America for nothing other than the American dollar. To hell with the health of Americans!

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