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american population
retirement age
life expectancy
medical care
men and women
Health Care Economics
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health Care Economics

The demand for health care is considerable in the United States, and the supply of physicians is not large enough to meet that demand (Nusbaum, 2009). This problem is only likely to get worse in the coming years. This is because doctors are aging and those that will reach retirement age are going to be leaving the career which will lessen the supply. The supply of doctors will have further stresses as doctors that are graduating are doing so at a pace that is not going to keep up with the growth of the population (Manning, 2003). The final reason that the supply of doctors going to be exceeded by demand is that the doctors who are graduating now are spending less time as doctors and more time with their families (Shangraw & Whitten, 2007). These factors will be discussed.

The advancement of medicine has helped the health of the American Population tremendously (Nusbaum, 2009). As near back as the 1900’s the life expectancy for men and women combined in the United States was 49.2 years. BY 1950 that age had climbed to 68.1, and in 1997 the combined life expectancy of men and women in the United States had climbed to 76.5. Advancement has come at a cost. The cost is that Americans are living longer, but they are sicker (Manning, 2003). As American age, they need more medical care, and much of that medical care is advanced requiring the oversight of a physician (Novick, Morrow, & Mays, 2008). The trouble is that there are an insufficient number of doctors to see are growing population, and that problem is only going to get worse (Nusbaum, 2009).

The supply of physicians is not able to meet the patient demand. This problem is not likely to be satisfied in the next decade (Nowakowski, 2007). Some areas of country, particularly rural regions are having significant shortages now (Morris, 2009). The problem of physician shortages has many causes. One of the causes is that the number of physicians that are retiring is exceeding the number of doctors who are coming into the field (Nusbaum, 2009). This is especially true of primary care physicians (Manning, 2003). Currently, the number of primary care physicians that are of retirement age is 10% (Nusbaum, 2009). This number is projected to grow to 15% by the year 2020. One-half of the doctors aged 50 to 65 years of age plan to retire, or reduce the numbers of hours they work in the next three years. The number of retiring primary care doctors will exceed the number of physicians that are being produced and make the problem worse.

The number of doctors that are produced every year has averaged 3% of the nation’s population in the last twenty years (Getzen, 2007). As those doctors that are retirement age begin to leave the profession, they will do so at a greater rate than the 3% of new physicians that are produced (Nusbaum, 2009). As primary care physicians begin to retire, the shortage of doctors will only compound the problem (Manning, 2003). In addition to that, a smaller percentage of doctors are going into primary medicine. Instead they are going into specialties and sub-specialties (Getzen, 20007). In an effort to meet the demand, some new schools have opened recently, but this too is too few too late (Lofton, 2008). Even if a school opened today, it would take 10 years before the first class of physicians graduated, so it is not a quick fix.

In addition to the losses related to retiring physicians, the population is expanding. The United States Population is expected to expand by 18% by the year 2020 (Manning, 2003). Given the graduation rate of 3%, one can see that even if the retirement rate stays steady, the number of people that will need coverage will expand (Getzen, 2003). This rate exceeds the growth of new physicians even if no new parts of the population need to care. Legislation that is set to be enacted to expand coverage to between 19 and 47 million people will only overwhelm the physicians currently working, or those that will graduate in the next 10 years (Morris, 2009). There is simply not enough supply to see the new patients that will be born, or newly acquire health insurance.

Doctors who are graduating today are concerned with balance in their lives (Shangraw & Whitten, 2007). They do not want to work the 60+ hours a week of the doctors just a generation before them. Instead, they want to have time with their families (Nusbaum, 2009). 60% of graduating physicians are female, and given biology, they will need to take time away to have babies, and extended periods with their families (Shangraw & Whitten, 2007).

To replace a doctor that is working 60+ hours a week, will take at least 1.5 if not 2 full-time physicians from the generation Y to get the same coverage. Generation Y doctors will not be baited into working longer hours. The amount of time that they are willing to expend on treating patients is inelastic, as any amount of money will not have them working more (Getzen, 2007). The future supply of doctors is not going to meet the future demand.

The supply of current physicians does not meet the demand of patients wishing to see them now (Nusbaum, 2009). The expanding rolls of the aging population will only expand as time passes. Aging with the sickly population is an expanding number of physicians that will be retiring at an accelerated rate over the next several years (Novick, Morris, & Mays, 2008).

The graduating numbers of physicians is staying the same as the population swells, and the newly graduating physician is not interested in committing their entire life to medicine, but only a portion, which will further stress the need for care (Getzen, 2007). Current legislation is not taking this into account (Morris, 2009). The die has been cast for a momentous change, only one has no way of knowing how it will turn out.

References Getzen, T. E. (2007). Health economics and financing, (3rded.). Hoboken, NJ: John Wiley & Sons, Inc. Lofton, L. (2008, October 27). Rural healthcare challenges abound in communities around state. Mississippi Business Journal. 30(43), pB7-B11. Manning, J. (Dec 30, 2003). Doctor shortages, particularly of specialists, threaten health care system. Milwaukee Journal Sentinel. p.: NA Morris, M.G. (October 3, 2009). Will the doctor be in? The Daily Journal. 136(187): pp.1, 3A. Novick, L.F., Morrow, C.B., and Mays, G.P. (2008). Public health administration: Principles for population-based management, (2nd ed.). Sudbury, MA: Jones and Bartlett, Inc. Nowakowski, S. (Sept. 3, 2007). Physician shortages real barrier to universal health care. San Diego Business Journal. 28(36): p43(1). Nusbaum, N.J. (Oct. 2009). Commentary: Physician retirement and physician shortages. Journal of Community Health. 34(5): pp. 353-356. Shangraw, R.E. & Whitten, C.W. (Dec 2007). Managing intergenerational differences with academic anesthesiology. Current Opinions in Anesthesiology. 20(6): pp558-563.

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