A recent Wall Street Journal article published on 4/12/2010 by Suzanne Sataline and Shirley Wang again revisits the physician shortage in the U.S. which is expected to grow considerably over the coming years. While many organizations have been warning of this shortage, the message may finally be gaining traction since the passage of the new federal healthcare bill.
"Experts warn there won't be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges."
While the healthcare bill does try to encourage people to enter the medical profession as physicians and American medical schools have increased enrollments, nothing has been done to date to address the limitations on residency positions.
One proposed solution to the physician shortage is to recruit increasing numbers of foreign physicians to practice medicine in the U.S. However, foreign trained physicians must complete a U.S. residency program before they are able to obtain a licence to practice medicine in any of the U.S. states. The article estimates that approximately 13% of current residency slots are filled by foreign physicians. With residency slots still at a premium, encouraging foreign physicians to immigrate to the U.S. may not be enough.
The article certainly suggests that much more must be done to prevent catastrophic shortages in the future and from the foreign physician's perspective, that fix must address both obstacles to immigration status and access to residency slots in the U.S.
The article can be read in its entirety through this link -- http://online.wsj.com/article/SB10001424052702304506904575180331528424238.html?KEYWORDS=medical+schools
CHICAGO – A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called "Doctor."
ReplyDeleteFor years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics.
Those newly insured patients will be looking for doctors and may find nurses instead.
The medical establishment is fighting to protect turf. In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients.
Nurse practitioners argue there's no danger. They say they're highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.
"We're constantly having to prove ourselves," said Chicago nurse practitioner Amanda Cockrell, 32, who tells patients she's just like a doctor "except for the pay."
On top of four years in nursing school, Cockrell spent another three years in a nurse practitioner program, much of it working with patients. Doctors generally spend four years in undergraduate school, four years in medical school and an additional three in primary care residency training.
Medicare, which sets the pace for payments by private insurance, pays nurse practitioners 85 percent of what it pays doctors. An office visit for a Medicare patient in Chicago, for example, pays a doctor about $70 and a nurse practitioner about $60.
The AMA argues the title "Dr." creates confusion. Nurse practitioners say patients aren't confused by veterinarians calling themselves "Dr." Or chiropractors. Or dentists. So why, they ask, would patients be confused by a nurse using the title?
The feud over "Dr." is no joke. By 2015, most new nurse practitioners will hold doctorates, or a DNP, in nursing practice, according to a goal set by nursing educators. By then, the doctorate will be the standard for all graduating nurse practitioners, said Polly Bednash, executive director of the American Association of Colleges of Nursing.
Many with the title use it with pride.
"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.
The best U.S. study comparing nurse practitioners and doctors randomly assigned more than 1,300 patients to either a nurse practitioner or a doctor. After six months, overall health, diabetes tests, asthma tests and use of medical services like specialists were essentially the same in the two groups.
"The argument that patients' health is put in jeopardy by nurse practitioners? There's no evidence to support that," said Jack Needleman, a health policy expert at the University of California Los Angeles School of Public Health.
Other studies have shown that nurse practitioners are better at listening to patients, Needleman said. And they make good decisions about when to refer patients to doctors for more specialized care.
hi blake, i read this one too and was soooooo amazed and actually glad! As an RN especially those with BSN can now have a long and fulfilling career as an RN. We have lots of room to grow from NPs, to CCRNS, CNOR, CRNA etc etc!
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