Thursday, November 8, 2007

Doctor Shortages - What's It All About, Alfie?

What’s it all about, Alfie?

Is it just for the moment we live?

What’s it all about when you sort it out, Alfie?

Are we meant to take more than we give?

Or are we meant to be kind?

And if only fools are kind, Alfie?

Then I guess it's wise to be cruel.

And if life belongs only to the strong, Alfie,

What will you lend on an old golden rule?

As sure as I believe there's a heaven above, Alfie.

I know there's something much more.

Lyric to Alfie, 1960’s popular song

Suddenly people want to become doctors.

I see by the latest two issues of the American Medical News that becoming a doctor is back in vogue.

The Oct.22 -23 issue runs this piece “We Have More Students, Now What?” Anticipating population growth and doctor shortages, Florida is adding four medical schools with total class sizes of 515 new students, and California is planning two schools with 192 new students. The “Now What?” part is whether Congress will fund residences to support these new students once they finish medical school.

The Nov. 5 article , “Record Number Vied for Medical School Slots, ” notes medical school applications for 2007-2008 boomed, with 31,496 applicants for allopathic schools and 11, 500 for osteopathic schools. Now only were there new applicants, but they had the highest MCAT and grade point averages on record. So much for the notion that medicine is no longer attracting the best and the brightest.

What’s it all about?

1) It’s about the imperfect art of predicting physician workforce demands. Maybe it’s all supply and demand. In the early 1980s, experts said it was excess supply. In the early 2000s, those in the know said it was excess demand. They predicted shortfalls of 50,000 by 2010 and 200,000 by 2020. Today, Florida says it will fall 6000 doctors short by 2012, and California estimates a 5,000 to 17,000 shortage by 2015. I’d like to think it’s more than supply and demand.

2) It’s about health reform and next election - about how generous the next administration will be in funding medical residencies. The Council of Graduate Medical Education (COGME) – the organization Congress set up to track workforce trends, financing, and training issues – has lost its funding. This has resulted in a disconnect between the nation’s need for more medical residents and the government’s drive to reduce costs of residency training.

3) It’s about the natural cyclic mood and meaning swings
of young people as they prepare for the future.It’s their growing economic awareness of the physician shortage. Now they seem to feel is a good time to step into the breech. It’s the realization that there’s something beyond materialism – altruism, giving back, wanting to help others, and a renaissance of the arts, religion, and spiritual needs.

I can vouch for the latter first hand. My son, Spencer, a nationally known poet and author of forthcoming book on becoming a priest. Spencer has been in retail for 10 years. He has decided to become an Episcopal priest focusing on hospice. When I asked,”Why are you doing this? “ Spencer replied, “Dad, the dying want to know they made a difference. The living seek inspiration, hope, and meaning to their lifes. Maybe I can help show them how.” Maybe he can. And maybe those crowds of young people entering medicine at this critical time can too.

How do you – you physicians out there in the trenches – account for this renewed passion to become doctors?

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