The Physician Shortage: Projections, Causes, and Solutions
Impact on Quality of Care
The physician shortage also is felt by patients due to its negative effect on quality of care.
Timely access to care is 1 of the 6 dimensions of health care quality identified by the Institute of Medicine's report, Crossing the Quality Chasm (Institute of Medicine. Washington, DC: National Academies Press; 2001. Crossing the Quality Chasm: A New Health System for the 21st Century ). The Agency for Healthcare Research and Quality cites improvements in morbidity, mortality, and cost savings as benefits of timeliness of care (National Health Care Quality Report. 2004. [June 26, 2005]. at: http://www.qualitytools.ahrq.gov/qualityre- port/browse/browse.aspx?id=5077)
The shortage of physicians can cause patients to grow discouraged and put off needed diagnostic tests and exams until their conditions become acute. In some cases, patient care delayed can be patient care denied.
Potential Solutions
There are a variety of steps which, taken in concert, could alleviate the physician shortage. These include:
Increased funding for physician Graduate Medical Education (GME). Federal funding for physician residency training is provided through the Centers for Medicare and Medicaid Services (CMS) at hospitals and other healthcare facilities nationwide. As was referenced above, that funding was capped by Congress in 1997, with only one limited increase since. Without additional federal funding, the supply of new physicians is unlikely to keep pace with demand.
Legislation has been submitted to Congress over the last several years to increase federal funding of physician GME, but so far it has failed to gain traction.
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