Dueling Opinions: What’s challenging the physician workforce?

What are some challenges in medical education and the physician workforce the pandemic highlighted?

Dr. David Battinelli: There’s no question the U.S. has superb healthcare if it’s defined by the number of excellent doctors. The problem is there’s a severe maldistribution. We don’t have a lot of doctors in the rural communities, which has been true for a long, long time. But what the pandemic brought forth was we’re also short of a lot of doctors even in heavily populated areas, mostly the inner city.

Dr. Alison Whelan: The pandemic made us learn on the fly. Just as it forced changes in healthcare, it also shed light on changes related to medical education. One thing, while not really new, is that COVID brought to the spotlight the incredible importance during times of crisis of a highly effective patient care team. Schools are really rethinking, “How do we increase our interprofessional education?”

How would you describe the progress in addressing equity issues and achieving a more diverse healthcare workforce, especially physicians?

Battinelli: I think we’re at a very early stage. … The metrics, the criteria, all the ways people get accepted into medical school don’t favor less-privileged students. Until we change some of those metrics, we are going to have a hard time bringing the right kids in, and we’re going to have to put programs in place to help support those who need a little bit of extra catch-up time.

Whelan: If you look at the last two years, there are some promising trends, but we clearly have a long way to go to ensure we have the diverse workforce that mirrors the diversity of our country. I also think we’re making progress because we are beginning to look at what systemic racism means. And, importantly, looking at data to see what efforts work and where we’re being successful.

Download Modern Healthcare’s app to stay informed when industry news breaks.

What about some other systemic issues that need to be addressed in physician education?

Battinelli: One of the big things people talk about is student debt. And that’s very real. But I don’t think making medical school free would drive people to choose work in other environments because the market forces are clear. The amount of money we pay in what I call direct patient care disciplines—internal medicine, family medicine, psychiatry, general surgery—is not nearly what we pay highly subspecialized fields.

Whelan: People who get into medical school typically started thinking about it at a relatively young age. And those who enroll often have role models, advisers or other support. But that’s not the case for many others. So it’s thinking about who we aren’t reaching and pathway programs to reach further into colleges that may have more of our underrepresented medicine students. Even back to high school.