Did Bad Policy Cause the US Physician Shortage?

As it stands, the physician shortage is a pressing concern for equitable care in the US. Without enough care providers, American medical treatment will only become more inaccessible and expensive for a wide swath of the population. 

Ending the doctor shortage should be one of our highest priorities, but was it bad policy that caused the physician shortage in the US in the first place? Politics has a way of fostering corruption through lobby and special interest groups, which then twist policy in the best interest of corporations. Is that what happened here?

To solve the physician shortage, we must first understand its causes. Here we look for bad policies that might be contributing and how we might go about changing these policies for the better. 

Explaining the Physician Shortage

First, we’ll discuss the shortage itself. 

For a long time, the US has struggled with limited availability of care. Reports indicate that over 80 million Americans don’t have adequate access to care as a combination of a lack of resources, insurance, and trained medical staff. And the problem is only set to get worse. 

By 2032, the US could be short by as many as 122,000 primary care physicians. This will leave hundreds of thousands — perhaps millions — of individuals without consistent healthcare. Meanwhile, the tighter supply of healthcare professionals will drive up demand, leading to higher prices across the industry. With 66.5% of bankruptcies tied to medical issues already, we’re in for a difficult situation. 

The physician shortage will reach a critical point soon. This is due to a combination of factors coming into play all at once and further narrowing the supply of medical professionals. These factors include:

  • One-third of practicing physicians will reach retirement age within the next decade.
  • The population of those over 65 will increase by 48% within the next decade.
  • Rising rates of chronic disease are increasing the demand for care.

All these factors and more will have devastating consequences when it comes to the accessibility and affordability of care. Since the US already does not do well by these measures, we cannot afford to lose progress through the loss of doctors and other care practitioners. 

But can policy make a real difference in preventing a worsening shortage? If bad policy helped create this situation, then policy can likely help us out of it, as well. 

Policies That Played a Role

From the mistakes of a flawed “surplus” narrative to state licensing requirements, bad policy has directly influenced the current physician shortage. These aren’t the only problems, of course. Systemic discrimination, stigmatization of Medicaid, and entrenched inefficiency abound in the US healthcare system. However, certain actions of the government have left a marked impact on the growth of the medical field, and these are the policies we’ll explore here:

●     GMENAC Recommendations

The Graduate Medical Education National Advisory Committee (GMENAC) was a committee established by the US government back in 1976 to study the physician workforce and provide policy recommendations. What followed were a series of reports that advised legislation and private industry pressures towards the shrinking of the physician pool. This should be done, the committee believed, to prevent a “surplus” of physicians that would be sure to come.

The healthcare industry, bandied about by the American Medical Association, accommodated the reports. Medical school moratoriums were put in place, class sizes were reduced, and the US effectively cut its supply of doctors. It wouldn’t be until 2005 that the moratoriums were ended. By then, far from a surplus, we’d already created a shortage.

●     Scope of Practice Laws

These laws are more recent and represent state-by-state measures to restrict how nurse practitioners and physicians assistants are allowed to treat patients. Scope of practice laws vary by location, with some states now allowing Nurse Practitioners (NPs) full practice without the supervision of a physician. 

These laws were designed as a method of protecting patients. The intent was that by mandating oversight in a medical practice by a fully trained physician, patients would receive better and safer care. The reality is that these scope of practice laws don’t do much to protect patients while instead increasing costs, bureaucracy, and decreasing access to care.

Scope of practice laws limit a physician’s time and decrease the availability of other trained professionals, as well. To combat the physician shortage, these policies will need to be changed. 

●     State Licensing Requirements

Similarly, every state has its own licensing requirements for medical providers. These requirements mean that only care providers specifically licensed in a certain state can practice there without having to jump through hoops to obtain new certifications. 

While intended as a means to protect patients from being treated by untrained providers, these requirements aren’t so effective in the modern, digital world. Our highly connected society, complete with telehealth services, should have the capacity to allow doctors to go where they are most needed. But licensing requirements mean that physicians often have to wait up to 12 weeks to start providing care in a new state.

The COVID-19 pandemic shifted some of these rules, as the need for adaptability during a public health crisis proved that we need streamlined regulations. As it stands, licensing requirements only further limit the supply of physicians available to treat patients. 

Reshaping American Care

These bad policies have helped bring about the physician shortage by limiting who can provide what care and who can practice where. But in the modern world, we need flexibility and accessibility more than ever.

Instead of fighting an imagined threat of a “surplus” of physicians for decades, the government could have instead worked on incentivizing the distribution of care providers to regions that need them most. Good schools, transportation, and local amenities help draw professionals to any location. With more doctors in underserved areas, the physician shortage won’t have as drastic of implications.

Image Source: Pexels

Meanwhile, we must end bad policies if we hope to reshape American care for greater accessibility. This starts with opening up and incentivizing students from a young age to enter the field and streamlining bureaucratic red tape to allow for more flexible care.

You too can make a difference by supporting legislation and ordinances that strive for these results in your own community. Even by voting in a local election, you can make your voice heard in the battle for a better America.