The Nov. 11 cover story (“What doctor shortage?” p. 14) discussed physician shortages more in the context of primary-care shortages. It is clear that given the present patient-care demand, there are not enough graduating physicians, advanced-nurse practitioners, pharmacists or physician assistants to provide adequate and timely primary care. Real disruptive innovation in the process such as telemedicine, retail clinics and group appointments might alleviate these shortages.
The major issues we anticipate involve shortages of surgical specialists. The Association of American Medical Colleges projects a shortage of 46,000 “non-primary-care” specialists by 2020. My colleagues and I previously calculated that the U.S will have a shortage of more than 29,000 surgeons in seven common surgical specialties by 2030 (Williams, Satiani, Thomas, Ellison; Annals of Surgery, 2009).
A recent paper by Dall and colleagues in the journal Health Affairs also indicates that it is specialty docs who will be in short supply, including vascular surgery, neurologic surgery and general surgery. My specialty, vascular surgery, is expected to be the hardest hit, with a 31% projected increase in demand by 2025. This is primarily because of our aging population. It does not seem likely that we will be able to train nurse practitioners, pharmacists and physician assistants to do specialty surgery by 2025.
Dr. Bhagwan Satiani
Professor of clinical surgeryOhio State University College of Medicine, Columbus