Outdated policy contributing to a worsening physician shortage

Doctors and other healthcare professionals have long made tireless sacrifices to treat patients and provide quality care. Their sacrifices have become even more apparent during the COVID-19 pandemic, with medical personnel experiencing unrelenting stress, extended hours on the job and fatigue on the front lines. These challenges have left many in the community burned out and even considering leaving the healthcare industry.

Their expertise is vital to the health and well-being of our citizens. In addition to the ongoing pandemic and the need to treat long-term effects of COVID-19, our population continues to age. The demand for high-quality, accessible medical care is increasing.

One way to help meet this need is to ensure that we’re teaching an adequate number of future physicians and other healthcare providers.

To ensure we are prepared for future public health emergencies and are able to respond to evolving challenges, we must have a well-trained physician workforce. However, just the opposite is occurring—we face an increasingly growing shortfall. A recent analysis of physician supply and demand by the Association of American Medical Colleges shows the U.S. is expected to face a shortage of up to 124,000 physicians by 2034.

In rural areas like my home state of Arkansas, the lack of specialty doctors is especially concerning. Without doctors close by to provide treatment, patients with complex medical conditions are oftentimes forced to travel hundreds of miles from home to receive care. Our communities and their economies depend on access to life-saving and preventive care, which underscores the need for an ample pipeline of medical students.

The warnings of an impending physician deficit were raised well before the COVID-19 pandemic, but the public health emergency’s consequences have led to increased urgency to address it. Investing in training and implementing strategies that support educating the next generation of doctors is critical. One solution to reduce the physician shortage: boost the number of Medicare-supported residency positions.

For more than 20 years, the arbitrary cap on the residency slots funded by Medicare—the primary source of payment for doctors-in-training—has remain unchanged. This has contributed to the provider shortage and also prevented medical school graduates from continuing their training where they want to live and work. 

As medical school enrollment and graduation rates continue to grow, the Medicare-funded Graduate Medical Education position cap has been a hindrance. Smaller, more rural states like Arkansas face an acute need for medical providers, but up to half of medical school graduates in the state are forced to seek residency training elsewhere due to a lack of available positions. That often results in a loss of future physicians given the tendency for residents to practice close to the communities where they complete their training.

Last year, Congress increased the number of Medicare-supported GME positions by 1,000. While this represents modest progress, it isn’t sufficient to replace the rate of physicians retiring or leaving practice for other reasons.

For the last several years, my colleague Sen. Bob Menendez (D-N.J.) and I have been leading legislative efforts for change. We recently introduced the Resident Physician Shortage Reduction Act to lift the cap on the number of Medicare-funded GME positions and increase the number by an additional 14,000 over seven years. Our bill will enable us to better provide access to quality healthcare in rural and urban communities.

Access to well-trained primary-care and specialty doctors results in longer lives and better healthcare outcomes. By lifting the antiquated cap on training slots for medical school graduates, we would be making progress toward ensuring access to quality care for all.