America’s health care system is exhausted. The pandemic, followed by inflation, regulations, and worker shortages are making it unrealistic for many people to receive medical care.
These elements, combined with increasing financial burdens, insurance restrictions, escalation of patient medical needs, and increasing volume of insured patients has created an environment where physician practices cannot keep pace – and they have had enough.
Our national physician shortage statistics are alarming. Projected estimates now show many states will suffer healthcare access shortage by 2030. An increasing patient load will require over 150,000 additional doctors to provide basic care.
What Happened?
20 years of falling Medicare physician reimbursement rates resulted in many practices closing. The long-feared physician shortage is here, and patients will suffer.
Two out of three surveyed doctors say they experienced burnout and depression during the pandemic. In fact, one in five physicians said they intended to abandon medicine within the next few years. Almost one in three said they would reduce their working hours.
More than 50% of practicing physicians are in their last decade in the work force. Medical school applications are rising but that is not an instant solution. Training and educating a specialist physician takes a decade. Recruiting international medical graduates is difficult due to immigration barriers.
Because physician Medicare payments have decreased so drastically, with more cuts planned for next year, no business could expect to survive this massive drop in revenue. These cuts are now exacerbated by high inflation, rising personnel costs, shortages, endless insurance denials, and the increased price of everything. For most practices, it is impossible to sustain these constant financial blows.
When doctors lack resources and need to keep their practices open, many reduce their hours, continue to use old technology, hire less staff, limit the number of new Medicare patients they accept, or stop seeing Medicare patients altogether.
Many seniors are receiving letters notifying them that their doctor will no longer provide Medicare services. This then leads to a search for a replacement, and too often medical decline during the transition. This practice is affecting families with anyone who depends on Medicare.
Physician Demand is Critical
80 million Americans lack access to primary care. Most of our population has no access to an infectious disease specialist. Complete lack of cardiac care is a reality for one-third of Black Americans. Pregnant people in many states cannot find OB/GYN care. Very few rural counties have pediatric ophthalmologists or dialysis centers.
Stop Criminalizing Healthcare
Treatments that are widely recognized as safe are now subject to scrutiny and denials, and that fact has radically changed the health care landscape for both patients and physicians. Health care workers are often the target of lawsuits and persecution for their beliefs. This has caused many high school graduates to reconsider where they will practice and if they will attend medical school at all.
We must stop penalizing, but rather encourage physicians to seek mental healthcare. Physician suicide rates are 50% higher than the general population. Of course, not all suicide can be attributed to professional burnout, but the pandemic fallout continues to cause widespread and lasting repercussions for doctors and patients alike.
Physicians are often reluctant to seek mental healthcare due to fear of endangering employment. This is due to the outdated and stigmatizing language used on medical board and health system forms that require an applicant’s past mental health treatment to be disclosed. 25% of healthcare workers said they have not sought mental health help because due to concerns their medical board or employer will act. That is not acceptable.
Seeking therapeutic interventions early helps prevent crisis. If left untreated, the trend will adversely affect patient safety. We must aggressively push for this outdated language to be changed and promote mental healthcare for physicians. This will allow physicians to prioritize their own mental health and seek care for stress related mental illness, substance use disorders, and more. The changes need to happen now, before more doctors abandon medicine altogether.
The Scope-of-Practice for Nurse Practitioners
More than 23 states allow NPs to evaluate patients, diagnose, order tests, interpret results, initiate, and provide treatments. They are trained, ready, and can do many of the basic functions that doctors perform. Unfortunately, state practice laws often restrict what NPs are allowed to treat or require oversight by a physician.
Allowing nurse practitioners to practice to the full extent of their scope of training has a track record of success. Evidence shows us that waiving scope-of-practice requirements for NPs during the COVID pandemic led to fewer cases and that expanding SOP in other states could have prevented COVID-related deaths. Researchers highlight evidence that expanding scope-of-practice for NPs has an increased likelihood of patients receiving primary care from NPs than states with restrictive SOP laws.
Expanding the scope-of-practice of nurse practitioners will not solve the doctor shortage, but it would increase patient access to quality medical care and reduce the pressure for doctors.
Encourage Physician Population Growth
More students are applying for medical school, but the rate of acceptance has not increased proportionally. The national acceptance rate has gone from 52% in 2002 to 30% in 2021.
Expanding the total supply of healthcare providers. As the population grows, we should consider adopting laws that allow physicians to be licensed to practice in more than one state or gain licenses in others states more quickly.
Automate Administrative Burdens
We must reduce healthcare administrative burdens. The overused, inefficient prior authorization process and increasing denials contribute to physician burnout. We hear about it, but what are we doing to help? Healthcare workers felt the pandemic’s weight deeply. Many are still struggling, and most won’t ask for help, and it could be too late.
When workers are no longer able to cope with pressures and constantly changing rules and regulations, they quit. Qualified and experienced physicians who spent decades building a career are completely breaking down due to exhaustion and being overwhelmed by administrative backlogs and constant denials that create frustrated patients and physicians.
This picture of our current system is broken and has earned a horrific reputation. All physicians, across all states and specialties, continue to carry tremendous burdens that leave us angry and hopeless in increasingly worrying numbers. Physicians are simply done with the quagmire and are turning their backs on the profession to save their own health.
Insurer concocted and inefficient prior authorization process that healthcare underwriters use to try to “control costs” are outdated and time consuming. Physicians and their staff spend an average of two business days a week just completing prior authorization paperwork, including care approvals, and appeals to the rising denial rates that denies care for common treatments. This process not only frustrates doctors and drives up health care costs, but it’s also unfair for patients.
Nearly 80 percent of physicians say they’ve had patients forego treatment due to prior authorization battles with their insurance company. 75% of practices said prior authorization delays led to more office visits, which adds to financial burdens for both patients and practitioners. Some states have recently passed comprehensive prior authorization reforms, but far more changes need to happen quickly to give doctors the financial support they need to take care of us.
Continue to Expand Remote Care
Telehealth services improves competition, cuts transportation costs, and allows access to quality care in underserved locations. The shortage requires change that will solve problems like increasing delivery of quality primary health care.
Virtual OfficeWare Healthcare Solutions
There are steps we can make today that impact our ability to retain the physicians we have and bolster our physician workforce so our nation can better prepare to respond to an aging population, and the next public health crisis we may ultimately endure. Automating administrative burdens is fast, inexpensive, and effective. Learn more about how you can help your practice reduce stress and workloads through automation and outsourcing by contacting us today.