During the early months of the Covid pandemic many doctors would not treat the virus. My wife’s doctor, for instance, had a sign that read she didn’t treat Covid and patients with Covid or Covid symptoms were barred from entry. I heard similar stories from a number of people. Many medical offices were closed and isolating at home seemed to be the most common therapy until patients became sick enough to visit an emergency room or qualified for a hospital bed. Later in the pandemic as more was known about the virus doctors began experimenting with treatments.
In the early months of 2020, doctors were left responsible to treat a little-known virus that prompted the worst pandemic the world had seen in a century – risking their lives in the process. During the study timeframe, from March 2020 to December 2021, 622 more physicians died than expected, according to a recently released study.
Believe it or not, data shows that doctors treating Covid were not at greater risk than others, including doctors who did not treat Covid.
Physicians had much lower excess mortality than the general population, perhaps indicative that protective equipment and workplace measures were effective, the researchers wrote.
Despite a potentially higher risk of being exposed to COVID-19, active physicians had a lower risk of being infected than non-active physicians.
Wow! That is amazing. Yet, Covid took a toll on doctors and other health care providers. Many decided to retire, while others suffered burnout from the long hours of treating the disease.
The pandemic has exacerbated many chronic challenges for the U.S. health system, including the shortage, burnout and inequitable distribution of healthcare workers. More than 230,000 healthcare providers left the profession in the first two years of the pandemic alone.
Many doctors are among the Baby Boom generation, who were born between 1946 and 1964. Many are retiring and becoming patients themselves.
America is an aging country, which stands to make the problem worse. Our need for healthcare rises drastically as we age, and the needs of our aging population have increased at a much faster pace than the supply of healthcare workers. As a result, the U.S. faces a projected shortage of between 37,800 and 124,000 physicians within the next 11 years. We are already experiencing a punishing shortage of providers that has led to reduced access to care and longer wait times for appointments.
There is definitely a shortage of primary care providers. Part of the shortage is the result of medical training. Those medical graduates who specialize tend to earn anywhere from 50% to 100% more than primary care physicians. One doctor told me that he wanted to become a primary care physician and his professors and mentors told him “no he didn’t.” He said the pressure to specialize came early in his training and it was not just about the additional money specialists earn. He said medical school professors encourage medical students to specialize. Those who want to do primary care are often considered less worthy than those who want to become specialists.
Primary care is an important medical service, although it is not cost-saving like many public health advocates believe. The following is what the LA Times had to say but is most likely inaccurate.
The lack of accessible primary care feeds the cycle of this country paying a lot more for complex and expensive care than we do for more cost-efficient prevention as well as early detection and interventions. The result is that we fail to manage conditions like diabetes and high blood pressure before they lead to more severe outcomes such as heart attacks and strokes.
Medical graduates must go through a residency program to legally practice medicine in the United States. Congress capped the number of federally-funded residencies in 1997 out of fear that there would be a doctor surplus in the coming years. As a result, more than 10,000 medical graduates do not match to a residency program each year. These are all potential physicians who could treat Americans but most will never practice. Recent legislation expanded the number of residency slots by 1,000 over five years but more could be done.
In addition to growing gaps among types of providers, we also have inexcusable inequities in where healthcare workers are located and who they reach. Even before the pandemic, approximately 80% of the rural United States was classified by the U.S. government as medically underserved. Communities of color often see hospital closures or other removals of service that limit their access to care.
It is an unfortunate fact that few doctors want to work in rural areas and most prefer to work in situations where they are paid well. That generally means working in affluent areas where most residents have health insurance. A good way to train more primary care physicians would be to create more primary care residency slots, some of which could stipulate working in a rural area for a few years. Some states also fund some residency slots since a majority of medical graduates stay and work in the state where they were trained.