Implications of Physician & Nurse Shortage

Blog post by Colin Hung

According to the Association of American Medical Colleges (AAMC), the United States will see a shortage of up to 122,000 physicians by 2032 as demand outstrips supply. The situation is similar for nurses. The American Nurses Association (ANA), predicts that there will be 100,000 more positions available than registered nurses available to fill them by 2022.

The shortage is not unique to the US. Canada, UK, Australia, Germany and other countries anticipate the same physician and nurse challenge in the years ahead.

The biggest factor driving the demand is the aging population. Our longer lifespans means more people will develop and live with chronic conditions which in turn drives the need for healthcare professionals. Technologies aimed at helping people age gracefully and the “Age at Home” movement are meant to improve the quality of life and decrease the cost of care as we age, but neither significantly reduce the overall demand for nurses and physicians.

Telemedicine is often cited as a potential solution to the physician shortage, however, I do not believe that it will solve the deficit of physicians and nurses that we will face over the next decade. Certainly telemedicine will allow us to be more efficient at utilizing our healthcare resources, but I have trouble seeing how this technology alone will make up for 122,000 physicians and 100,000 nurses.

So what are potential solutions?

Many point to Artificial Intelligence as a way to solve healthcare’s issues and it’s not hard to see why. Just imagine being able to press a button on your mobile device, describe your symptoms, take a photograph of the affected area and get a medically accurate diagnosis + recommended treatment instantaneously. That is the dream of IBM’s Watson initiative and many other technology titans (and startups!).

However, I believe that we are still a few years away from the technology maturing to the point where society begins to accept it. One day having an AI doctor visit will be commonplace, but between now and then, we will all be riding in self-driving cars, watching goods being shipped on self-driving trucks and eating food prepared by automated chefs.

To address the shortage in the near term, the US and other countries are focusing on expanding the capacity of nursing/medical schools and hiring more foreign trained professionals.

According to the American Association of Colleges of Nursing (AACN), many state governments are funding initiatives to hire and attract more nurses to their regions through tax, bonus and other financial incentives. They are also partnering with local medical schools to expand their capacities so that more professionals can be trained.

Hiring foreign trained nurses has long been a practice at US healthcare organizations. Every year, thousands of nurses trained in Canada, India, the Philippines, Peurto Rico, and other countries take the NCLEX exam to become licensed in the US. Many who pass, are snapped up by healthcare organizations looking to fill vacant positions.

It is not as easy for foreign trained physicians to practice in the US. A foreign trained physician must pass the same board exams and complete 3-7 years of residency in the US, even if they have years of experience seeing patients or working at a hospital in their home country. This is a significant deterrent for experienced physicians, especially when there are so few residency spots available to even US-based medical students.

There is already movement to open more residencies in the US, but there has not been much progress in recognizing the training of physicians by foreign institutions. As the shortage becomes more acute, however, change may happen rapidly – especially as countries like Australia, UK and Canada are beginning to look at relaxing medical requirements for foreign-trained physicians.

Chat Questions

Join me on #hcldr, Tuesday September 3rd at 8:30pm EDT (for your local time click here) when we will explore the physician and nurse shortage in more detail:

  • T1 Have you experienced or seen signs of the nursing/physician shortage? What impact did it have on you?
  • T2 Where do you stand on foreign trained health professionals? Why has nursing been more accepting of foreign trained professionals?
  • T3 Telemedicine can mitigate the impact of the shortage of physicians, but it’s not a long-term solution. What technologies or industry changes would address the shortage of nurses & physicians?
  • T4 Would you recommend your daughter/son/niece/nephew a career as a physician or nurse given the demand…and the burnout rate? Why or why not?

References

“New Findings Confirm Predictions on Physician Shortage”, AAMC News, 23 April 2019, https://news.aamc.org/press-releases/article/2019-workforce-projections-update/, accessed 1 September 2019

Miriam A Knoll MD. “Doctoring the Doctor Shortage”, Forbes, 7 March 2019, https://www.forbes.com/sites/miriamknoll/2019/03/07/doctoring-the-doctor-shortage/#339136e176f3, accessed 1 September 2019

Esmail, Nadeem. “Canada’s doctor shortage will only worsen in the coming decade”, Fraser Institute, https://www.fraserinstitute.org/article/canadas-doctor-shortage-will-only-worsen-in-the-coming-decade, accessed 1 September 2019

Tully, Shawn. “The Job Market for Doctors Is Booming. Here’s What It Means for You”, Fortune, 20 May 2019, https://fortune.com/2019/05/20/doctors-job-market-shortage/, accessed 1 September 2019

Briskin, Perrie. “Why we should let more foreign doctors practice in America”, Vox, 7 August 2019, https://www.vox.com/first-person/2019/8/7/20757511/universal-health-care-doctor-physician-shortage-burnout, accessed 1 September 2019

Kavilanz, Parija. “The US can’t keep up with demand for health aides, nurses and doctors”, CNN Money, 4 May 2018, https://money.cnn.com/2018/05/04/news/economy/health-care-workers-shortage/index.html, accessed 1 September 2019

“2018 NCLEX Examination Statistics”, National Council of State Boards of Nursing, 2019, https://www.ncsbn.org/2018_NCLEXExamStats.pdf, accessed 1 September 2019

“Nursing Shortage”, American Association of Colleges of Nursing, https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage, accessed 1 September 2019

“Workforce”, American Nursing Association, https://www.nursingworld.org/practice-policy/workforce/, accessed 1 September 2019

Grant, Rebecca. “The US Is Running Out of Nurses”, The Atlantic, 3 February 2016, https://www.theatlantic.com/health/archive/2016/02/nursing-shortage/459741/, accessed 1 September 2019

Whelan, Jean C. “Where Did All the Nurses Go?”, Penn Nursing, https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/, accessed 1 September 2019

Esposito, Lisa. “Immigrant Nurses: Filling the Next US Shortage”, US News, 29 March 2017, https://health.usnews.com/wellness/articles/2017-03-29/immigrant-nurses-filling-the-next-us-shortage, accessed, 1 September 2019

Jennifer Thew RN. “5 Things You Should Know About the Nursing Shortage”, HealthLeaders, 28 September 2018, https://www.healthleadersmedia.com/nursing/5-things-you-should-know-about-nursing-shortage, accessed 1 September 2019

Spross, Jeff. “America is on the verge of a nursing crisis”, The Week, 25 September 2018, https://theweek.com/articles/797779/america-verge-nursing-crisis, accessed 1 September 2019

Haddad LM, Toney-Butler TJ. “Nursing Shortage”, StatPearls, January 2019, https://www.ncbi.nlm.nih.gov/books/NBK493175/, accessed 1 September 2019

Image Credit

Photo by Sam Wheeler on Unsplash

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