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Are International Medical Students The Answer To The Looming Physician Shortage?

Howard Dean wrote an op-ed defending the use of foreign international medical graduates:

Today, young physicians with degrees from international medical schools face skepticism from some in the American medical community. That strikes me as misinformed thinking, given the large number of international medical school graduates practicing in the United States, alongside American medical school graduates, and given that the American medical system depends on them to fill the growing doctor shortage.

The federal Health Resources and Services Administration predicts there will be a shortage of approximately 55,000 physicians in the United States by 2020. We simply can’t build the capacity to meet our growing needs for skilled physicians — especially given budgetary constraints on schools receiving government subsidies. Even if the new medical schools now in the planning stages all come to pass, they won’t turn out enough primary care physicians to meet urgent needs in urban and rural communities.

I actually don’t have a lot to say about the IMG thing,  I have worked with and hired many IMG’s and their skill and quality vary as much as US graduates. But this whole argument seems to miss the central point regarding the projected physician shortage. The supply of new medical graduates is not the choke point, under the current state of affairs. The choke point is the number of residency training slots. Read more »

*This blog post was originally published at Movin' Meat*

More Physician Temps Needed For Doctor Shortage

The use of temporary physicians is rising, filling in until permanent physicians can be hired amid the ongoing shortage of doctors nationwide, a locum tenens firm has found. The company estimates between 30,000 and 40,000 physicians worked on a locum tenens basis in 2010.

The survey, by Staff Care, polled hospital and medical group managers about their use of locum tenens. Eighty-five percent said their facilities had used temporary physicians sometime in 2010, up from 72 percent in 2009.

Psychiatrists and other behavioral health specialists were the most sought-after specialty (22 percent of all requests), followed by primary care physicians, defined as family physicians, general internists and pediatricians (20 percent) and internal medicine subspecialists (12 percent). Hospitalists were 9 percent.

According to the survey, the primary reason cited by 63 percent of healthcare facilities was to fill a position until a permanent physician could be found. Forty-six percent of healthcare facilities now use locum tenens physicians to fill in for physicians who have left the area, compared to 22 percent in 2009. Fourteen percent use locum tenens doctors to either help meet rising patient demand for medical services or to fill in during peak times, such as flu season. Fifty-three percent use locum tenens physicians to fill in for physicians who are on vacation, ill or for other absences.

Most locum tenens physicians plan to stick with temporary practice in the short-term, the company noted. Sixty percent said they plan to practice on a locum tenens basis for more than three years, 28 percent for one to three years and 12 percent for less than a year.

Freedom trumps pay, the company noted, as 82 percent cited flexibility as a benefit, compared to 16 percent who identified pay as a benefit. Other reasons cited for working as a locum tenens include absence of medical politics (48 percent), travel (44 percent), professional development (21 percent) and searching for permanent practice (20 percent).

The locum tenens option is important to maintaining physician supply, the company concluded, because during a time of physician shortages it allows doctors who might be considering full retirement to remain active in medicine.

*This blog post was originally published at ACP Internist*

Hospital Medicine: Trying To Recruit A Lead Doctor

How can you find a hospitalist director with enough experience to lead a team of hospitalists? Recruitment can be tough. A reader recently asked for my opinion:

I am searching for a Hospitalist to lead a department in the state of XXX and I’m not finding any leads. On a good day, I can find a new graduate interested in moving to XXX, but I have not been able to find an experienced Hospitalist who has the supervisory experience to lead a department.  …and this is an opportunity (full time & permanent) for good pay with an excellent work/life balance. Where would you suggest I look for my Lead Hospitalist?

My first thought is for you to purchase a booth at the Society of Hospital Medicine’s yearly conference and then bombard all the hospitalists with pens and squeezy balls while trying to pocket an email and home address or two. Read more »

*This blog post was originally published at The Happy Hospitalist*

Doctors’ Opinions And The Impending Physician Shortage

By Stanley Feld MD, FACP, MACE

Sixty three percent of physicians are unhappy with the implications of President Obama’s healthcare reform plan. The government has reduced reimbursements arbitrarily over the last decade.

Physicians have had an underlying mistrust of government healthcare policy. Congress and especially Pete Stark mistrust physicians. Pete Stark feels all physicians game the healthcare system.

I believe there is some abuse of the healthcare system by a small percentage of physicians. I also believe congress has a lack of understanding of medical practice expenses, the value of physicians’ intellectual property and skill sets. Read more »

*This blog post was originally published at Repairing the Healthcare System*

The New-Patient Fallout: How It Might Affect Primary Care

Sunset on Hanalei Bay by Alaska Dude via FlickrWith the prospect of 32 million new patients clamoring for care comes sorting out who will see them all. New medical schools are opening and students say they relish the idea of entering a market that will demand their services. American College of Physicians member Manoj Jain, M.D., offers a more tempered view of how the fallout might affect primary care. (AP, American Medical News, Fort Worth Star-Telegram, Memphis Commercial Appeal)

Even Hawaii has a shortage, especially in primary care, but also cardiology and orthopedic surgery. It’s hard to believe recruiters couldn’t sell Hawaii as a destination. (Honolulu Advertiser)

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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