The high number of physicians in the United States has been influenced less by patient demand and more by federal policies and the needs of training institutions. Federal policy that had been based on an alleged shortage of physicians has contributed to an augmented number of medical schools and medical graduates. The number of specialty residency positions has been influenced by the training institutions, assisted by accreditation processes that emphasize academic standards rather than on the medical specialists required.
While there is a consensus that the number of physicians is higher than needed, the physicians are not equitably distributed across geographical regions (Shi and Singh, 2008). The majority of the physicians are concentrated in urban and metropolitan areas leaving the rural areas and low-income inner cities with a dire shortage of physicians. This national supply of physicians has several implications for the St. Bernard’s Health System (SBHS).
First, it implies that the SBHS’ outpatient clinics located in suburban communities have a high number of physicians who may be more than the demands of the patients. Second, it implies that the SBHS’ outpatient clinics located in the inner-city and rural communities may be in shortage of physicians. This shortage of physicians in the inner-city and rural areas translates into reduced access to care, low quality of health services, and increased waiting times for the residents as well as a backlog of work for the few physicians working in these areas.
The suggestions offered by the Council have some weaknesses. First, reducing the amount of pay for the physicians would discourage many physicians from working in the organization and the physicians would move to organizations or areas where the pay is much higher. This can create physician shortages for the organization even for its clinics based in the metropolitan areas. Second, the suggestion of hiring fewer physicians and more non-physician practitioners would increase the rate of unemployment among these highly qualified and trained professionals. This translates into a waste of productive resources (Simoens, 2004).
The SBHS can undertake an alternative approach to dealing with the issue of physician supply. This approach involves creating new areas of professional responsibilities for the employed physicians. The new areas may include community service responsibilities, systems-building responsibilities, and lifetime learning and retraining. In the community service area, physicians would be involved in disease prevention and education of the wider community such as schools, prisons, and shelters among others. In the systems-building responsibility, the physicians would be involved in carrying out outcomes research to enhance medical practice and quality of care.
In the lifetime learning and retraining areas, physicians would be involved in continuous learning to enhance their knowledge and skills and to subsequently improve the quality of healthcare provided. This approach is preferred for several reasons. First, it would avoid the problem of unemployment of physicians that could be created by hiring fewer physicians or cutting down their pay. Second, the approach would assist the SBHS to take advantage of the national supply of physicians by engaging them in more worthy causes that do not necessarily involve their day-to-day medical practice. Third, the approach would create additional demands for services from the wider community (Wennberg, Goodman, Nease, and Keller, 1993).
Reference List
Shi, L., & Singh, D.A. (2008). Essentials of the U.S. healthcare system. Canada: Jones & Bartlett Publishers.
Simoens, S. (2004). Experiences of Organization for Economic Cooperation and Development countries with recruiting and retaining physicians in rural areas. Australian Journal of Rural Health, 12, 104-111.