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Retirements by baby-boomer doctors, nurses could strain overhaul

RightinNYC

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Retirements by baby-boomer doctors, nurses could strain overhaul

Since the passage of the health-care law in March, much has been said about the coming swarm of millions of retiring baby boomers, and the strain they will put on the nation's health-care system. That's only half the problem. Overlooked in the conversation is a particular group of boomers: doctors and nurses who are itching to call it quits. Health-care economists and other experts say retirements in that group over the next 10 to 15 years will greatly weaken the health-care workforce and leave many Americans who are newly insured under the new legislation without much hope of finding a doctor or nurse.

Nearly 40 percent of doctors are 55 or older, according to the Center for Workforce Studies of the Association of American Medical Colleges. Included in that group are doctors whose specialties will be the pillars of providing care in 2014, when the overhaul kicks in; family medicine and general practitioners (37 percent); general surgeons (42 percent); pediatrics (33 percent), and internal medicine and pediatrics (35 percent). About a third of the much larger nursing workforce is 50 or older, and about 55 percent expressed an intention to retire in the next 10 years, according to a Nursing Management Aging Workforce Survey by the Bernard Hodes Group. New registered nurses are flowing from colleges, but not enough to replace the number planning to leave the profession.

"Moving into the future, we see a very large shortage of nurses, about 300,000," said Peter Buerhaus, a nurse and health-care economist and a professor at Vanderbilt University. "That number does not account for the demand created by reform. That's a knockout number. It knocks the system down. It stops it."

...

In a article for the Journal of the American Medical Association, Buerhaus and colleagues Douglas Staiger and David Auerbach predicted that there will be at least 100,000 fewer doctors in the workplace than the 1.1 million the federal government projects will be needed in 2020 under the health-care overhaul.




This is hardly a partisan thing, so let's avoid using this thread to bicker about the health care bill. Something needs to be done about the ridiculous system in which the AMA is allowed to set quotas for the number of doctors that graduate each year. There is absolutely no way we can hope to keep costs under control when there is a shortage of doctors.
 

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Retirements by baby-boomer doctors, nurses could strain overhaul

Well, only briefly, one would think.
In another ten or fifteen years, all the Boomers will be dead, and then there will be significantly fewer people in the US; specifically, fewer elderly people.
 

RightinNYC

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Well, only briefly, one would think.
In another ten or fifteen years, all the Boomers will be dead, and then there will be significantly fewer people in the US; specifically, fewer elderly people.

It actually won't work that way.

http://pewhispanic.org/files/reports/85.pdf

p. 16, Figure 7.

The nation’s elderly population will more than double in size from 2005 through 2050, as the baby boom generation enters the traditional retirement years. The number of working-age Americans and children will grow more slowly than the elderly population, and will shrink as a share of the total population.

The percentage of elderly people will steadily increase over the next 20 years from 12% to 19%. From there it will remain flat at 19% until 2050.
 

Redress

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This represents a problem with health care(among other things), whether the health care system was overhauled or not.
 

1069

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It actually won't work that way.

http://pewhispanic.org/files/reports/85.pdf

p. 16, Figure 7.



The percentage of elderly people will steadily increase over the next 20 years from 12% to 19%. From there it will remain flat at 19% until 2050.

Well... cool. In 2050, I'll be 75 years old.
At least I'll have plenty of company.
We'll be sitting around the senior center arguing the relative merits of Nirvana versus Pearl Jam.
 

rathi

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While problematic, I see this an opportunity to end the domination of doctors in medical care. Its time we assembly lined the medical process. Too much work is being done by overqualified generalists that should be done by low-skill specialists. Operating a particular machine or performing one specific kind of test should require a short training course to get certification, not years in medical school. Doctors still have the their place in the system, but only when their particular talents are needed for a job that can't easily be done by someone else.
 

Orion

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Another solution is to expand the education system. There has been an exponential decline in medical schools in the U.S. over the past century. The trend has been the same in Canada and Great Britain. Limiting med school seating is how the industry maintains competitive salaries, but it is placing an artificial ceiling on the supply of doctors and medical staff.

The government should mandate that med schools open more seats, and provide the financial incentive to do so. It should also expand coverage to the alternative health care sector which is already providing huge benefits to a lot of people.
 

RightinNYC

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This represents a problem with health care(among other things), whether the health care system was overhauled or not.

Absolutely true, I probably should have included that in the OP.

While problematic, I see this an opportunity to end the domination of doctors in medical care. Its time we assembly lined the medical process. Too much work is being done by overqualified generalists that should be done by low-skill specialists. Operating a particular machine or performing one specific kind of test should require a short training course to get certification, not years in medical school. Doctors still have the their place in the system, but only when their particular talents are needed for a job that can't easily be done by someone else.

I'm 100% in support of this approach, but I have a hard time envisioning the people in this country accepting this. The only thing anyone will hear is "the government is trying to take away my doctor and replace him with a nurse tech!"

It's the same reason why we can't tell people that they aren't entitled to all the care they want without regard for expense.
 

rathi

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I'm 100% in support of this approach, but I have a hard time envisioning the people in this country accepting this. The only thing anyone will hear is "the government is trying to take away my doctor and replace him with a nurse tech!"

That is correct, although I suspect people would warm the system once they understood its benefits. Kaiser has implemented some aspects of such a system for getting medical tests or vaccines, and most people appreciate how much less time they waste getting it done. Ideally, the government would simply loosen requirements and dodge the flak by letting hospitals make the choice themselves. The financial motives would likely be enough incentive to make it happen.
 

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Retirements by baby-boomer doctors, nurses could strain overhaul

This is hardly a partisan thing, so let's avoid using this thread to bicker about the health care bill. Something needs to be done about the ridiculous system in which the AMA is allowed to set quotas for the number of doctors that graduate each year. There is absolutely no way we can hope to keep costs under control when there is a shortage of doctors.

Congress has complete control over this issue.

They allocate funds for residency(?) programs for budding doctors.
 

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Lately, most of the doctors I've seen have been immigrants- Indians or middle easterners, many of them female.
I suspect that's the solution to our problem.
 

Wiseone

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While this may not be the best, or preferred solution, but one solution we do have is to simply move the age of retirement for gov't programs to more accurately reflect the extended life expectancy. At least the very least it should mean less people on the systems for a shorter amount of time, of course its not that simple and will surely be met with all the fury of the elderly.
 

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I've always known old people would be the end of us all.
 

Lord Tammerlain

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Lately, most of the doctors I've seen have been immigrants- Indians or middle easterners, many of them female.
I suspect that's the solution to our problem.

The Phillipenes is a good source of nurses, as well
 

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So the answer to the problem, from what I've heard, is to open the flood gates on any jackass who wants to cut people open, reduce their salaries, and allow anyone and everyone wanting to see a doctor for any reason to do so.

If this is even close to what's going to happen, you don't have to be Confucius to see the future. You're going to see private insurance companies take people with means to pay for a bit better care, and highly specialized and better doctors take only those, and nobody on ObamaCare. Then the dregs who free-ride the system will take the rest of the crop who C-minused their way through undergrad and wrote a 250 word essay on "wy i wont to bee a doktor".

If that's the case, fine for me. Let the Wal-Mart greeter take his Henry Ford inferior care and limp away, for all I give a damn. Just don't take away my right to quality care because you feel a need to socialize a field.
 

Orion

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Lately, most of the doctors I've seen have been immigrants- Indians or middle easterners, many of them female.
I suspect that's the solution to our problem.

Yeah but you have to basically be rich in order to get re-certified if you come from a non-western country.
 

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I've always known old people would be the end of us all.

And this is why we can label you as a heartless liberal. Care only for yourself and leave the elders in the dusts.....

Sorry for being off-topic but this kind of thinking has gotten us to where we are. "Move over grandma!" Pfft, they raised you for christ sakes, and you can toss them overboard just like that?
 

Ikari

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This is hardly a partisan thing, so let's avoid using this thread to bicker about the health care bill. Something needs to be done about the ridiculous system in which the AMA is allowed to set quotas for the number of doctors that graduate each year. There is absolutely no way we can hope to keep costs under control when there is a shortage of doctors.

Tell them to get back to work!
 

donsutherland1

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Something needs to be done about the ridiculous system in which the AMA is allowed to set quotas for the number of doctors that graduate each year. There is absolutely no way we can hope to keep costs under control when there is a shortage of doctors.

That's one of the major reasons I believe anti-competitive barriers, including the use of licenses to restrict competition, have to be addressed. Nurses and physicians who are licensed in Europe, parts of Asia, etc., are competent to practice in the U.S. and should be permitted to do so without having to obtain a separate U.S. license. At the same time, quotas that artificially restrict the domestic production of doctors in U.S. medical schools should be abolished.
 

RightinNYC

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Congress has complete control over this issue.

They allocate funds for residency(?) programs for budding doctors.

Also completely true. It's something that has to be dealt with on both ends.

So the answer to the problem, from what I've heard, is to open the flood gates on any jackass who wants to cut people open, reduce their salaries, and allow anyone and everyone wanting to see a doctor for any reason to do so.

If this is even close to what's going to happen, you don't have to be Confucius to see the future. You're going to see private insurance companies take people with means to pay for a bit better care, and highly specialized and better doctors take only those, and nobody on ObamaCare. Then the dregs who free-ride the system will take the rest of the crop who C-minused their way through undergrad and wrote a 250 word essay on "wy i wont to bee a doktor".

If that's the case, fine for me. Let the Wal-Mart greeter take his Henry Ford inferior care and limp away, for all I give a damn. Just don't take away my right to quality care because you feel a need to socialize a field.

The absurd restrictions on the number of seats in medical schools means that we're already far past the point where it's serving the purpose of keeping out unqualified individuals. There are thousands of eminently qualified students each year who are not admitted to any medical school, which is a phenomenon not seen in any other professional field.

Ex. There are 130 MD-granting schools and 199-JD granting schools. The average student at the lowest of the ranked medical schools has a 3.6 GPA and a MCAT at the 80th percentile. Those numbers are roughly equivalent to the average student at the 25th ranked law school.

When the "worst" med school in the country has more qualified students than 88% of law schools, something is seriously wrong (on both ends).

And this is why we can label you as a heartless liberal. Care only for yourself and leave the elders in the dusts.....

Sorry for being off-topic but this kind of thinking has gotten us to where we are. "Move over grandma!" Pfft, they raised you for christ sakes, and you can toss them overboard just like that?

Actually, it's the "no one can dare question spending on senior citizens" attitude that is most responsible for where we are today.
 

MCS117

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Actually, it's the "no one can dare question spending on senior citizens" attitude that is most responsible for where we are today.

It's more of the fact that the gov't took money out of the Social Security system and now the seniors need to withdraw that got us where we are today...
 

RightinNYC

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It's more of the fact that the gov't took money out of the Social Security system and now the seniors need to withdraw that got us where we are today...

We're talking about health care, not social security. While SS certainly has problems, they're dwarfed by Medicare and expenses for the elderly in general.
 

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Yeah but you have to basically be rich in order to get re-certified if you come from a non-western country.

Yes, I'm acquainted with a couple that runs a "traditional chinese medicine" joint; they do acupuncture and stuff, too.
They were both MDs in China, but can't afford to or don't choose to be re-certified to practice as MDs here.
They told me that they left China, at least in part, because the pollution was too bad, and they didn't think it was healthy to raise their son (who has serious asthma) there.
 

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Yes, I'm acquainted with a couple that runs a "traditional chinese medicine" joint; they do acupuncture and stuff, too.
They were both MDs in China, but can't afford to or don't choose to be re-certified to practice as MDs here.
They told me that they left China, at least in part, because the pollution was too bad, and they didn't think it was healthy to raise their son (who has serious asthma) there.

Most people who can afford to leave China usually do, if not for the crazy government then for the health factors.

I don't blame them for going the TCM. In the U.S., most states don't regulate TCM so they can setup shop and start giving treatments without resistance. Compare that to having to spend potentially tens of thousands of dollars in re-cert examinations and even mandatory education upgrades, just to have the chance to maybe get hired by a hospital.

I wish the U.S. had more licensing for TCM though. There are lots of effective practitioners out there but without licensing you could just as easily end up seeing a hack and that creates a bad reputation for the field.
 
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