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ASPR industry news and highlights - Summer/Fall 2016
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Decades into crisis, kids still suffer from shortage of psychiatrists
The problem, outlined in a report on the country’s mental health system, was a “dearth” of child psychiatrists that forced primary care doctors to treat mentally ill youngsters, a “triage” environment that it said needed to change. Read more 

The epidemic of physician burnout
In a December 2015 article from the Mayo Clinic Proceedings, researchers reported that 54.4 percent of physicians responding to a large national survey reported at least one symptom of burnout. In an identical survey in 2011, the burnout rate was 45.5 percent—representing a rise of almost 9 percent in only three years. Of equal concern, they found that physicians’ satisfaction with their work-life balance had declined from 48.5 percent in 2011 to 40.9 percent in 2014. In contrast with the high rate of burnout among physicians, only 28 percent of working adults in the general population show symptoms of burnout, and that rate has remained stable over the last several years. Read more 

Health systems urge Senate to revamp or repeal Stark law
Executives of large health systems recently told Congress that an anti-kickback law could hinder value-based payment models. Read more

Young physicians don’t want to care for the nation’s elderly
Out of the nation’s 383 geriatric fellowship positions in 130 programs, only 192 of them were filled earlier this year. In West Virginia, which is home to the third-oldest population in the US, the trend is highly palpable. Over the past three years at West Virginia University-Charleston, no medical school students enrolled in any of its four geriatric fellowship programs. Read more 

Medical school enrollment up 25 percent
New data show US medical school enrollment has grown by a quarter since 2002, adding more than 4,100 new students into the fold, according to a report released by the Association of American Medical Colleges. Read more 

Stark Law poses hurdles to value-based payment models, report warns
A law intended to prevent physicians from self-referring Medicare beneficiaries has caused problems for the health care industry and is in need of modification, according to a report released by Senate Finance Committee Chair Orrin Hatch (R-Utah), Lisa Schencker reports for Modern Healthcare. Read more 

Focus on value spurs hospitals to invest in primary care
As new payment models move to reward value-based care, many health care systems in the Minneapolis area invest in primary care to stimulate growth and prepare for future insurance contracts, reports the Minneapolis Star Tribune. Read more

Interstate physician licensing compact gets federal funding boost
As state medical licensing agencies seek to accommodate new health information technologies such as telemedicine while preserving professional integrity and patient safety, they’ll be getting a funding boost from the federal government. Read more 

Hospital Impact: Employment law changes pose challenges for providers
Providing excellent, compassionate, compliant patient care isn’t enough for healthcare organizations to remain viable today. As employers, these organizations must also comply with labor and employment laws, as they would any other health-facing legal mandate. Read more

RiverView Health: Community’s help sought in physician recruitment
The RiverView Health Community Physician Recruiter Incentive Program has been launched to engage the community in the effort to connect with and successfully recruit physicians to RiverView. In return, anyone responsible for igniting the spark that eventually brings a qualified physician to full-time employment at RiverView will be justly rewarded financially. Read more 

Rising administrative costs have small physician practices seeking safety in numbers
Executives at physician organizations are seeing an unprecedented number of small groups nearing decisions whether to go it alone, join a larger group or seek hospital employment. The Affordable Care Act and related changes over the past six years have increased administrative costs for physician practices, leading many to consider joining larger groups… Read more 

Recruiting best and brightest doctors
In 1981, Hatfield joined the Fort Wayne Police Department. Hatfield’s husband was also a police officer and worked third shift. But in 1986, her first child was born and after a few too many calls in the middle of the night as the public information officer for the police force, Hatfield decided it wasn’t quite right having two officers in the family with a newborn at home. Read more 

New research confirms looming physician shortage

Shortages particularly acute in specialties most needed by an aging population

Washington, D.C., April 5, 2016—Under every combination of scenarios modeled, the United States will face a shortage of physicians over the next decade, according to a physician workforce report released by the AAMC (Association of American Medical Colleges). The projections show a shortage ranging between 61,700 and 94,700, with a significant shortage showing among many surgical specialties.

The study, conducted by the Life Science division of the global information company IHS Inc., is an update to a 2015 report prepared on behalf of the AAMC and reflects feedback from the health care research community, as well as the most recent workforce data.

“These updated projections confirm that the physician shortage is real, it’s significant, and the nation must begin to train more doctors now if patients are going to be able to receive the care they need when they need it in the near future,” said AAMC President and CEO Darrell G. Kirch, MD.

The report aggregates the shortages in four broad categories: primary care, medical specialties, surgical specialties, and other specialties. By 2025, the study estimates a shortfall of between 14,900 and 35,600 primary care physicians. Non-primary care specialties are expected to experience a shortfall of between 37,400 and 60,300 physicians.

These findings are largely consistent with the 2015 report. In particular, the supply of surgical specialists is expected to decline, just as demand for physicians is growing. The study also finds that the numbers of new primary care physicians and other medical specialists are not keeping pace with the health care demands of a growing and aging population. 

As one example of how patient demand will surpass physician supply, Kirch cited that in 2014, 45 states had fewer psychiatrists relative to their populations than they had in 2009, despite more than 43 million adults in the United States reporting a mental illness. “As a psychiatrist, I have seen firsthand what it means for patients not to be able to receive the care they need. These projected shortages are very troubling and only reinforce the importance of ensuring that all patients have access to health care for their physical and mental well-being,” he said.

In addition to projected shortages of psychiatrists and primary care physicians, shortages of general and vascular surgeons will also be a serious problem, particularly for older patients who require two to three times the amount of specialty care to treat chronic conditions and age-related illnesses. 

As the US population ages, so too does the physician workforce, with one-third of physicians now over the age of 55, noted Kirch. “More physicians retiring over the next decade also will create challenges for patients who need access to health care,” said Kirch.

For the first time, the 2016 report includes a special analysis of the needs of underserved populations. These data show that if underserved patients had barriers to utilization removed, the United States would need up to 96,000 doctors today to meet patient needs.

“When you consider all the people who do not utilize health care—despite their need—because of financial, cultural, social, or geographic barriers, the physician shortage is actually much bigger. We are very concerned about equity in patient utilization of care and how we can address it going forward,” Kirch said.

To help alleviate the shortage, the AAMC supports a multipronged solution, which includes innovations in care delivery, better use of technology, and increased federal support for an additional 3,000 new residency positions a year over the next five years. Medical schools have done their part to increase the overall number of physicians by expanding their class sizes, and now Congress must approve a modest increase in federal support for new doctor training if the United States is to increase its overall number of physicians, according to Kirch. After graduating from medical school, all new MDs must complete a residency to be able to care for patients independently.

“We believe this is a measured approach to deal with a problem that has the potential to affect every American. It strikes a balance between our nation’s budget constraints and what medical schools and teaching hospitals believe is our responsibility to meet the needs of patients,” said Kirch. “Because it can take up to 10 years to train a doctor, our nation needs to act now.”


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