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Physician Shortages Real Barrier to Universal Health Care

In his documentary “Sicko,” Michael Moore argues that the U.S. government should provide universal access to health care, as do Canada and other industrialized countries.

Whether or not you agree with this premise, most do believe that the health care system needs to be more inclusive and provide faster access to quality care.

Suppose, however, that we could instantly create a system providing free health care for all. Would our problems be solved?

Unfortunately, the answer is no, for the simple reason that we do not have enough physicians or nurses to care for patients; not the current number of patients, and certainly not an increasing patient population.


Feeling The Pain

The United States is in the middle of a physician and nurse shortage, and in the next decade the problem is only going to get worse. Patients today already feel the pain (and health consequences) of limited availability of physicians and nurses.

If universal health care were implemented tomorrow, demand for medical services would rapidly escalate.

Not long thereafter, physicians and nurses would be harder to find than a needle in a haystack.

The nurse shortage has been building for years and is well documented.

Estimates vary, but experts agree that by 2020, the United States will need somewhere between 340,000 and 1 million additional nurses.

The good news is that a growing number of young people are applying to nurse training programs.

The bad news is that we do not have the faculty or facilities to train them.

Last year, nursing programs had to turn away more than 35,000 qualified applicants to four-year nursing programs.

Additionally, the nursing profession is aging right along with the general population.

Today, 30 percent of nurses are 50 or older and that number is expected to increase to 40 percent in just three years.

Soon, the overall nursing population may begin to shrink as more nurses are retiring , just when we need more clinicians to care for aging, very sick patients.

The doctor shortage has been more low-profile but is gradually receiving more attention.

Projections by the Association of American Medical Colleges and other groups indicate that the United States will be short as many as 200,000 physicians by 2020.

J. Edward Hill, M.D., former president of the American Medical Association, has compared the looming physician shortage to a pandemic.

In February, Sens. Harry Reid, D-Nev., Bill Nelson, D-Fla., and Joe Biden, D-Del., introduced the Resident Physician Shortage Reduction Act of 2007, a bill that would increase the number of doctors trained at teaching hospitals throughout the country.

That the doctor shortage is being recognized as a serious challenge is a positive development. The next step, however, will be harder.

It will take years to build new medical schools and to expand existing ones.


Residency Programs

In addition, both political will and government funding will be required to expand hospital-based medical residency programs in order to train doctors once they have completed medical school.

While nurse training offers a quicker turnaround, increasing the supply of nurses will also take more funding and more focus by political and health industry leaders than is being exhibited.

Increasing the recruitment of quality foreign-trained physicians and nurses can help address the clinical labor shortage poised to hit our country.

There are legislators listening to the needs of their community hospitals, who are attempting to alleviate the immigration barriers currently preventing such clinical assistance.

Unfortunately, even these relatively easy-fix legislative solutions are being held up in the power struggles of our political parties.

Promising more access to health care makes for good campaign rhetoric and controversial films.

However, neither political party will be able to deliver on the promise of expanded and improved care for all if we fail to train more qualified caregivers.

The time to begin this process is now.


Susan Nowakowski is president and chief executive officer of AMN Healthcare in San Diego, the largest health care staffing firm in the United States.

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