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Dr. Benjamin Brewer reports that "Even without health-care reform, the demand for family physicians is expected to surge by 2020, when the nation will need 140,000 family physicians, according to the American Academy of Family Physician's 2006 Physician Workforce Report. That's a 40% increase over the 100,000 family doctors at work in 2006."
We've all read about the health care crisis, ad nauseum it seems. The figures are frightening, and they aren't improving. As WSJ's reporting dc point out: "Low payments to primary care doctors are discouraging those of us in practice and are dissuading new doctors from entering the field. Just nationalizing health insurance by declaring Medicare for all isn't going to get the job done. Medical insurance coverage without a doctor to see is another big health problem -- not a solution."
What I found most intersting about the article was Dr. Brewer's comments on the reliance of the U.S. health care system for foreign-born physicians. "Until we adequately fund primary care, we're not going to get the health system Americans expect. Right now the U.S. is graduating about half the family physicians we'll need in the coming years, and the government proposes to cut funding to train more. The 2009 federal budget would abolish funding for training programs under Title VII of the Public Health Service Act, including Section 747 of the act, which provides the only federal grants for training primary care physicians.
To fill the primary care gap, we could flood the U.S. with foreign trained doctors. In fact, we're pretty much already doing that in our training programs. Fifty-six percent of doctors starting family medicine residencies this summer are foreign graduates. Foreign grads practice mainly in larger cities so that doesn't help overall distribution of doctors to smaller communities."
A solution to this looming crisis is health travel / travel for treatment / medical travel. With U.S. health care costs skyrocketing and a shrinking health care labor force, the best solution may well be for patients to travel to where the dotors are vs. the other way around. The quality of medicine abroad is no longer something to quesiton - as Dr. Brewer points out, many docotrs in the U.S. are foreign-born, and as Forbes magazine recently pointed out, many return to their home lands to practice. In short, the doctors 'over there' are frequently trained HERE, the only difference being that here, thanks to a chaotic third party managed care system, open heart surgery costs $200,000 while there (India, Thailand, Mexico) the cost is less than $10,000 - includling travel.
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