It is widely believed that any country’s healthcare system should work to increase patient access, care quality, and affordability. However, there is a severe physician shortage and maldistribution problem in the United States, especially among primary care physicians (PCPs) and mental health specialists in the countryside and low-income metropolitan regions (Mongelli et al., 2020). Large populations, particularly those who belong to minority groups and residents of rural areas, are underserved due to the spatial inequality caused by the concentration of doctors in urban areas. The geographical maldistribution might also be caused by the early retirement of doctors and demographic shifts.
Many factors might explain an imbalance between primary and specialty care in the United States. The common reason is that PCPs are switching to an internal medicine specialization or abandoning their practice in the middle of their careers out of unhappiness. The development of new medical technologies is what gave rise to specialty care. Moreover, specialty care providers earn more money than the average PCP. Unlike PCPs, they can also work flexible hours (Devi et al., 2021). Most students might find it appealing as most healthcare education in the US focuses on cutting-edge technologies, complex procedures, and tertiary service settings.
Both imbalance and maldistribution problems can be resolved by boosting physician remuneration as residents and fully qualified clinicians, not by current initiatives to expand the number of doctors who go through a broken system. Higher resident remuneration will lessen the significant economic burden that medical students currently carry. Residents avoid primary care because of the high debt load and limited ability to pay it off, which adds to its shortage. Higher remuneration for PCPs and those working in poor areas can also help to address the imbalance in the distribution of physicians. Increased PCP compensation will be more crucial as efforts to provide universal health insurance continue.
References
Devi, R., Goodman, C., Dalkin, S., Bate, A., Wright, J., Jones, L., & Spilsbury, K. (2021). Attracting, recruiting and retaining nurses and care workers working in care homes: The need for a nuanced understanding informed by evidence and theory. Age and Ageing, 50(1), 65-67.
Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus, 18(1), 16-24.