Sullivan: Shortfall of Professionals Must Be Solved

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The Arguments

• Daschle: Comprehensive Health Care Reform Is Long Overdue in U.S.
• Delgado: Health Care System Must Reflect the Values Of American Society
• Miller: U.S. Needs a Holistic, Cradle-to-Grave System of National Health Care
• Simmons and Neas: National Plan Must Be Product of Capitol Hill Bipartisanship
• Tanner: Reform Must Empower the Consumers
• Gephardt and Thompson: Steep Costs Damage Families, Businesses

What We Know

• Bigby: Massachusetts’ Rate of Uninsured Has Fallen Since Reform Passed
• Marchildon: O Canada — Exploding the Myths About Its Health Care System

Stakeholders Weigh In

• Brown: Cost Denies Many the Care They Require
• Grover: U.S. Teaching Hospitals Need Federal Support
• Kennedy: Retailers Are Already Shaping the Landscape

Ensuring Success

• Gingrich and Frogue: Congress Must Eliminate Fraud
• Keckley: Knowing What Works Is Critical
• Saputo and Belitsos: D.C. Needs to Catch Up to Public
• Waters: Telemedicine Boosts Access to Needed Care

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As the Obama administration and Congress work to reform the nation’s health care system, there is significant focus on reining in costs, expanding access to care and improving the quality of services provided.

However, considerable attention also must be given to our country’s critical shortages in the number of physicians, nurses, dentists and other health professionals, coupled with a lack of racial and ethnic diversity among them. This is aggravated by geographic maldistribution of health personnel and imbalances among the medical specialties.

There is a serious — and growing — shortage of physicians in primary care fields such as family medicine, pediatrics, internal medicine and obstetrics/gynecology. In 2006, the Association of American Medical Colleges warned of a pending shortage of physicians and urged a 30 percent increase in the number of graduates from U.S. medical schools. A deficiency of up to 20,000 physicians by the year 2015 has been predicted by the PricewaterhouseCoopers Health Research Institute.

In nursing, the shortage is severe. The Department of Health and Human Services has predicted that, by 2020, our country will have a deficiency of as many as 1 million nurses.

A shortage of 150,000 pharmacists has been projected also by the PricewaterhouseCoopers institute.

If these health manpower issues are not addressed simultaneously with other needed reforms, we will not achieve the stated goals of expanding access, improving quality and controlling costs. Even more ominous is the fact that these manpower shortages and imbalances are projected to become more critical if not resolved.

Beginning in the 1950s, in response to reports of a pending shortage of physicians, Congress provided funds and incentives to increase the number of health professionals. As a result, from 1956 to 1981 the number of U.S. medical schools increased from 80 to 127, and our annual graduation of physicians doubled, from 8,000 to slightly more than 16,000.

Today, with a growing and increasingly diverse population in the United States, there is a pressing need to resolve these manpower issues. But in contrast to the environment of some 50 years ago, for the past three decades, activities to increase the number of health professionals have not come from our leaders in Washington, D.C. Since 2001, however, in several states, new medical schools have opened, and several more are being planned. Private initiatives in Virginia, Nebraska, Florida and North Carolina have included the development of statewide alliances between academic health centers and colleges with significant enrollments of minority students to increase racial and ethnic diversity of entering students.

Because of the lack of significant federal health professions scholarships (again, in contrast to the period 1950-1975), many talented low-income students are discouraged from applying to health professions’ educational programs. Of those students who do matriculate, many graduate with student loan debts in excess of $150,000. The need to alleviate this large financial burden causes many of the new graduates to choose high-paying clinical specialties rather than careers in primary care, where they are most needed.

If not addressed, these health manpower shortages will frustrate efforts to improve access to health care and to enhance the health status of our citizens, and they will impede the goals of reducing costs and increasing the quality of health services. By imposing health insurance mandates on its employees and citizens, Massachusetts has succeeded in increasing the percentage of its citizens with health insurance to more than 98 percent. However, this has led to delays of up to several weeks in securing appointments with physicians for many in the Bay State. This circumstance has demonstrated that the provision of health insurance is only a half step in the process of providing unimpeded access to health services.