The disappearing US doctor

It occurs to me that there are two ways to address the problem of the growing doctor shortage:

The doctor is disappearing in America.

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.

Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.

Tasked with checkups and referring more complicated health problems to specialists, these doctors have the most consistent contact with a patient. But 65 million people live in what’s “essentially a primary-care desert,” said Phil Miller of the physician search firm Merritt Hawkins.

Without those doctors, our medical system is “putting out forest fires — just treating the patients when they get really sick,” said Dr. Richard Olds, the chief executive officer of the Caribbean medical school St. George’s University, who is attempting to use his institution’s resources to help alleviate the shortage.

Dr. Ramanathan Raju, CEO of public hospital system NYC Health + Hospitals, goes even further, saying the U.S. lacks a basic primary-care system. “I think we really killed primary care in this country,” said Raju. “It needs to be addressed yesterday.”

Interesting. 65 million people lack primary care. There are at least 61 million post-1965 immigrants. One way to assure that all Americans have sufficient health care is to repatriate those 61 million people. Wouldn’t having primary medical care be considered in the American national interest?

But I don’t see what the problem is. Have we not been repeatedly assured that those 61 million immigrants are here to do the jobs that Americans won’t do? I’m sure Dr. Dirka, Dr. Jose, Dr. Wang, and Dr. Awolowo will do a bang-up job, despite their lower average IQ, under the guidance of Dr. Raju.

The connection may seem a little strange to you, but just as the changing ethnic demographics significantly altered the behavior of Wall Street bankers, I suspect that they have also changed the specialties pursued by med school graduates.

The most likely solution is to relax the accrediting standards for med schools, which should have been done back in the 1980s.