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Excellent new must-read from @Robert_t_Orr explains, in gruesome detail, the deliberate engineering of US physicians shortages. https://www.niskanencenter.org/the-planning-of-u-s-physician-shortages/
Our story begins with HHS's Graduate Medical Education National Advisory Committee (GMENAC).
GMENAC's influential 1981 report warned of a looming physician surplus, and advised "immediate action" to curtail domestic training of physicians & admittance of physicians from abroad.
GMENAC's influential 1981 report warned of a looming physician surplus, and advised "immediate action" to curtail domestic training of physicians & admittance of physicians from abroad.
The "physician surplus" narrative had pernicious policy consequences.
- Medical school scholarships were scaled back.
- Stringent training requirements were imposed on residency programs.
- All while the federal govt gradually withdrew public funding for residency programs.
- Medical school scholarships were scaled back.
- Stringent training requirements were imposed on residency programs.
- All while the federal govt gradually withdrew public funding for residency programs.
Most devastating for the supply of physicians, however, was the de facto 1981-2005 moratorium on the establishment of new medical schools.
The number of M.D. annual entrants immediately fell in absolute terms from 16,600 in 1981 to a low of 15,800 thousand in 1989.
The number of M.D. annual entrants immediately fell in absolute terms from 16,600 in 1981 to a low of 15,800 thousand in 1989.
Ever wonder why D.O.s became all the rage?
Despite being alternative medicine, osteopathy doctors became increasingly mainstream as a kind of regulatory arbitrage around the moratorium on new MD schools
Yet in starting from a smaller base, D.O.s simply couldn't fill the gap.
Despite being alternative medicine, osteopathy doctors became increasingly mainstream as a kind of regulatory arbitrage around the moratorium on new MD schools
Yet in starting from a smaller base, D.O.s simply couldn't fill the gap.
The 1981-2005 moratorium on new medical schools drove our increasing reliance on physicians trained abroad.
That includes both J-1 visa immigrants, and US medical students forced to receive their education and training in foreign countries, particularly Mexico and the Caribbean.
That includes both J-1 visa immigrants, and US medical students forced to receive their education and training in foreign countries, particularly Mexico and the Caribbean.
Awareness of physician shortages began to spread in the early 2000s, with the Association of American Medical Colleges finally switching its tune to “shortage” in 2005.
But lasting damage was done. In 2018, the AAMC forecasted a shortfall of 43,000 - 121,000 physicians by 2030.
But lasting damage was done. In 2018, the AAMC forecasted a shortfall of 43,000 - 121,000 physicians by 2030.
In hindsight, the run-up in medical school enrollment during the 1960s and 1970s was simply a reflection of growing health care demand.
Unlike the US, Europe let its physician supply increase, which can be seen to this day in our relatively dismal MD : population ratio.
Unlike the US, Europe let its physician supply increase, which can be seen to this day in our relatively dismal MD : population ratio.
This article only touches on one of the several forces constraining the supply of doctors in the US.
Another is the length and cost of US medical education itself, as @Robert_t_Orr detailed earlier this year: https://www.niskanencenter.org/the-case-for-shortening-medical-education/
Another is the length and cost of US medical education itself, as @Robert_t_Orr detailed earlier this year: https://www.niskanencenter.org/the-case-for-shortening-medical-education/