Healthcare reform is fueling a dramatic rise in doctor shortages, with two new surveys showing the U.S. will face a shortfall of 90,000 physicians by 2025 and that one in five Americans already live in a region of the country with too few M.D.s.
As a result, doctors are more squeezed for time than ever, with some consumer health advocates suggesting the increasing crunch time is adding to doctor errors, including hundreds of thousands of errant drug prescriptions, surgical procedures, and other healthcare services.
Peter Hibberd, M.D., tells Newsmax TV’s “Midpoint” doctor shortages have reached crisis proportions and are only going to become more pronounced. That’s why it’s critical that patients take pro-active steps to be sure they find a reputable doctor, work closely with that physician to derive the highest-quality healthcare they can provide, and demand the time required to properly
“There are some [medical specialties] that have more needs than others,” says Dr. Hibberd, a board-certified physician and Newsmax contributor. “Primary care has been in a big loss for a long time, emergency medicines also in great need, but this [doctor shortage crisis] is encompassing the entire spectrum of medicine in America.”
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The upshot for healthcare consumers? Dr. Hibberd says the care for many patients that was once provided by doctors is now being handled by lesser-qualified professionals, such as a physician’s assistant or nurse practitioner. In the face of these changes, he says patients need to be strong advocates for their own care and demand to see a physician when they need medical attention — whether it’s in an emergency department, clinic, hospital or doctor’s office.
“Maybe we're going to have a system like other countries have where in order to see a doctor, you have to go to the hospital,” he observes. “Perhaps all the [healthcare providers] that you can see outside, will not be medical doctors. Perhaps they will be nurse practitioners and PAs — physician assistants. At the moment, that's how we're fixing our shortage.
But he adds: “That's not a solution, it's a patch….The problem now is when you go or I go to the emergency room now, two out of three times, you're going to see a non-physician to treat you [and] frankly the only way to make sure you're seen by a doctor is to insist that you ask to be seen by the doctor. In that case, you may need to be waiting hours more.”
To cope with shortages and reduce the risk of becoming a victim of doctor errors, Leana Wen, M.D., an emergency physician, tells Newsmax Health patients need to take steps to make the most of their doctor visits.
"We have a problem in our country with our healthcare system,” says Dr. Wenn, director of Patient-Centered Care at the Department of Emergency Medicine at George Washington University. “We know that doctors are under more pressure to see as many patients as possible in very little time and also doctors are not reimbursed for time with patients; we're reimbursed for things that we do to patients and, as a result, we just don't have the time to listen.”
Dr. Wen, author of "When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests," has come up with the following five guidelines to help you make the most of the short time you spend with your doctor:
Tell your own health story. Studies have shown that the vast majority of diagnoses can be made by listening to a patient discuss his or her medical history. Unfortunately, doctors sometimes steer patients toward a cookbook "chief complaint" or a series of "yes/no" answers. Learn to tell a succinct, effective story. Prepare and rehearse it.
Press your doctor on his or her diagnosis. Find out what your doctor is thinking, when it comes to diagnosing and treating you for any condition you may have. Ask for a list of all the possible diagnoses that could explain your symptoms. Make sure you and your doctor jointly devise a thorough list, handicapping the likelihood of each possible diagnosis.
Participate in your physical exam. If you're being examined, make sure you know what the doctor is looking for. Don't be afraid to ask about any findings. By partnering with your doctor, you can often come up with diagnosis without a lot of tests. And if you do need to further testing, make sure you understand how a particular test will help, as well as and what the risks and alternatives are.
Use common sense. Don’t just leave the doctor’s office without a working diagnosis that makes sense to you. Don't just assume the doctor must be right. Talk through your diagnosis with your doctor and make sure you understand how it will have an impact on your life and health. What are your treatment options, and what risks and benefits do they carry? What warning signs should you be on the lookout for?
Dr. Wen and other health experts say it’s critically important for patients to become strong advocates for their own health, in the face of doctor shortage. They cite a handful of factors in those shortfalls:
- Under Obamacare, more than 16 million previously uninsured Americans have entered the healthcare insurance system over the last two years, just as a growing number of doctors are nearing or surpassing retirement age.
- Too few medical students are able to secure the 3- to 7-year residency training programs at the country's teaching hospitals, which are required for them to work in medicine after they finish medical school. Federal regulations and funding deficits for those residency programs have capped the number of med students who can participate.
- Many doctors are abandoning solo practices, and being absorbed by hospital networks or are leaving the profession altogether in the face of increasing government regulations. That trend is likely to escalate under Obamacare provisions that aim to hold down costs by creating new "accountable care organizations" that take a team approach to patient care and pay providers in "bundled payments" as an alternative to fee-for-service practices.
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