In a shocking report (not really) released by the General Accountability Office (ie - the US federal government), they stated that there are fewer primary care docs now than there was about 10 years ago. The first thing I have to comment about is the name - "General Accountability?" - What's up with that? To whom are they accountable? Let me answer that - nobody!
Anyway, in this Associated Press article, the report goes on to say that in 2006, there were about 22, 146 American docs in residency programs across the United States. In 1995 (when I was in medical school), the number was about 23, 801. For the next few years after that, the number plateaued. Then, right when I graduated is when the fall started to happen.
"It is troubling to me that the number of Americans pursuing a career in primary care has declined," said Sen. Bernie Sanders, I-Vt. Overall growth in the number of primary-care physicians "has been totally due to the number of international medical students training in America," Sanders said. "We are increasingly dependent on international medical school graduates to meet our needs. Currently, one in four new physicians in the U.S. is an international medical graduate."These quotes just kill me. What do you mean legislators and the federal government don't know and cannot explain why this happened? It confuses and frustrates me because they are the ones, in my opinion, that CAUSED this situation. They did choose and continue to choose to reward specialists, especially those doing procedures, the higher payments. What happened when they did that? Read on...
For specialists, the number of Americans in training went from 45,300 in 1995 to 47,575 in 2006 and over the same period international specialists grew from 11,957 to 12,611, GAO said.Does anyone know who that is a picture of at the top of this post? That guy is Willie Sutton. That name should ring a bell to some of you - especially history buffs out there. He was one of the most prolific bank robbers of the early 20th century. When asked why he robbed banks, he is attributed with the famous quote, because "that's where the money is."
It's not rocket science. Why did the number of specialists grow during this time? Because that's where the money was (and is). Why did the number of primary care docs shrink? Because that is where the money is not. And, who is filling that primary care gap? It is international medical graduates.
I don't want to start an entire international medical graduates debate. I'm just saying that if graduates from US medical schools are not going into primary care (and that is happening), who are going to fill those residency/training spots?
So, one of these days, the legislators and the government will figure it out. Unfortunately, it will not be until medicare, medicaid, and social security go bankrupt. Or, when the voters (meaning patients) rise up and tell the government something like "Fix the Health Care System Now." Oh yeah, isn't this an election year? Maybe this year? But, probably not....