Thursday, July 26, 2007

Doctor Shortage? Increase Number of Med Schools

Go to Google and do a search for:

"Economist shortage" and you'll get 4 results.

"Truck driver shortage" and you'll get 1 result.

"Realtor shortage" and you'll get 3 results.

"Computer programmer shortage" and you'll get 32 hits.

"Attorney shortage" and you'll get 163 hits.

"Accountant shortage" and you'll get 445 hits.

Now try "doctor shortage" and you'll get 313,000 results!

Why the difference? Shouldn't a competitive, dynamic labor market eliminate shortages and surpluses of certain professions? Sure, but the market for doctors is neither competitive nor dynamic.

In fact, the number of medical schools today (125) is less than the number of medical schools 100 years ago (166), even though the U.S. population has increased by 300%. Consider also that the number of medical students in the U.S. has remained constant at 67,000 for at least the period between 1994 and 2005, according to this report, and perhaps much longer.

In contrast, the number of law schools in the U.S. is about 200, and we don't hear about any shortages of attorneys.

From the WSJ article "Doctor Shortage Hurts A Coverage-for-All Plan," Massachusetts faces a "critical shortage" of primary-care physicians, according to a study by the Massachusetts Medical Society, which found that 49% of internists aren't accepting new patients. Boston's top three teaching hospitals say that 95% of their 270 doctors in general practice have halted enrollment.

As it happens, primary-care doctors, including internists, family physicians, and pediatricians, are in short supply across the country. Their numbers dropped 6% relative to the general population from 2001 to 2005, according to the Center for Studying Health System Change in Washington. The proportion of third-year internal medicine residents choosing to practice primary care fell to 20% in 2005, from 54% in 1998 (see chart above).

Solution: Let's increase the number of U.S. medical schools to 200 (same as the number of law schools), and we won't hear about any more doctor shortages, just like we don't hear about lawyer shortages.


At 7/27/2007 10:53 AM, Blogger juandos said...

What part does the excessive amount of mal-practice law suits play in these numbers?

At 7/27/2007 11:25 AM, Anonymous Anonymous said...

From a lawyer in Michigan:

NO IMPEDIMENT to starting Medical Schools and you are dishonest to suggest to your students and readers that there is. If any University declines to start a Med School or any entrepreneur declines to start a Med. School it is for $$$$$ reasons ( OR shrinking applications in current schools - This is called DEMAND professor) To circulate the cartel junk is also DISHONEST. Why don't you open a Med. School---NO ONE will stop you----NO ONE. I bet Reed and Sowell and the entire Geo. Mason econ faculty will invest with you--Try them. Choose Wyoming for your location as you used that as an example to me.

At 7/27/2007 11:55 AM, Blogger Unknown said...

And how is he going to get AMA certification?

And why do you think enrollment is falling?

At 7/27/2007 4:48 PM, Blogger happyjuggler0 said...

While you are right that there is a problem with the AMA cartel, I don't know that I cna blame them for the general practioner shortage. Why isn't there a shortage of emergency room doctors, or surgeons, or any number of other specialties?

The problem here as I see it is price controls, the source of all shortages in a market economy. Insurance companies base there reimbursement payments to doctors and hospitals in significant part on what Medicare/Medicaid prices various things at. They mayuse different prices, than the government, but the general ratio remains the same. The government is essentially picking numbers out of a hat to create its prices, and is in effect short changing general practioners relative to other doctors.

Doctors respond to price signals as well as anyone else, and follow the money. When enough such doctors choose something else besides being a family doctor, you get fewer such doctors, and with enough of a difference in price you get a shortage.

I'm not sure how one can have proper market prices, and their resulting balancing of supply and demand, when third party payers (private insurers or government) are in charge of pricing.

At 7/27/2007 4:50 PM, Blogger happyjuggler0 said...

Grrrrr. I should preview my posts more often.

Practitioners, not practioners. :x

At 7/27/2007 8:58 PM, Blogger juandos said...

"From a lawyer in Michigan"...

Hmmm, isn't that the same state that elected a lady chock full of empty socialist rhetoric for govenor and has rising unemployment?

Its interesting that the contents of the Michigan lawyer's post was also long on socialist rant and short on substance...

Hmmm, must be mere conicidence, eh?

At 7/27/2007 9:27 PM, Anonymous Anonymous said...

To be more specific, its is only an internal medicine (generalist) shortage. There is no shortage of surgeons, dermatologists, cardiologists, or pathologists. Why? Perhaps because they all make around $400K where a generalists makes around $100K.

Now, it is true that specialists have to go to school for 2 to 4 more years but, for that kind of raise, who would'nt!

Medicare chooses to pay generalists a lot less than specialists. Thus, we will continue to have fewer and fewer generalists. The generalists, on the other hand, cannot charge more for their services (it is illegal if you accept Medicare) so the spread does not change.

Thus, another solution is to pay generalists more.

Adding more medical schools is unlikely to change anything. As it is, many US doctors received their MD degrees overseas (in some cases, on a nice Caribbean island).

At 7/29/2007 3:40 PM, Anonymous Anonymous said...

So the single payer system creates a shortage that would be filled in a true market system.


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