Looming Shortages in Specialty Medicine
Having attended the now annual July Alliance of Specialty Medicine Advocacy “Fly-In” in Washington DC over the past couple of years, I noticed a change (although subtle) this year. Besides the fact that the attendance was greater, more representatives and senators came to tell us their viewpoints (mostly Republicans), and DC seemed hotter than ever — this year there was a sense of urgency and an engagement among the attendees for action and solutions now.
The Alliance is a coalition of 13 national specialty societies whose collective goal is the preservation of a quality health-care policy that supports access to specialty care for patients. Each year, physicians from these different societies, including AGA, gather in Washington to go to the offices of their senators and representatives to speak in a collective voice for specialty medicine.
As a gastroenterologist, I, along with ophthalmologists, spine surgeons, dermatologists and others, pleaded our case to our respective representatives for our shared concerns. While some of the issues remained the same — the constant fight for fair Medicare reimbursement, repealing the sustainable growth rate formula and the Independent Payment Advisory Board, and tackling medical liability reform — there were some new issues that came to the forefront.
I learned that that U.S. will face an overall shortage of more than 130,000 physicians by 2025. One half of this shortage will come from specialty physicians. Growth in future demand for physicians will be highest among specialties that predominately serve the elderly. With 10,000 seniors aging into Medicare every day for the next 18 years, along with the influx of patients seeking access to care as a result of the Affordable Care Act, the need for our services will increase significantly. We need to ensure that we have enough gastroenterologists for the future.
On my Hill visits, I urged my Massachusetts representative and senators to address the workforce shortages in many specialties that will jeopardize access to care for our patients. Both the “Resident Physician Shortage Reduction Act” and the “Training Tomorrow’s Doctors Today Act” will improve the nation’s graduate medical education system and help preserve access to specialty care by increasing the residency slots by 15,000 over the next five years, with half of the positions going to training specialists.
While we all have been made aware of the crisis in primary care and the changes ahead to increase the number of primary care physicians, we need to make Congress aware that access to specialists is also threatened by an equal shortage of specialists. To ensure a fully trained specialty workforce for the future, it is apparent that we need to take steps now. We are all in agreement that the proposed legislation will begin to help improve the acute shortage of specialty physicians.
Our marathon for a sound federal health-care policy fostering patient access to the highest quality specialty care continues. Yet this year, I believe the crowds were cheering us on and there was a passion in the air. Practicing quality medicine is not the issue (we all agree to that). How to do it best is still the challenge and on all fronts, I felt we were getting closer to the finish line.