Can Telehealth Telemedicine Help Alleviate a Dire Physician Shortage?

Physician shortage? Yes, it is prevalent now in many areas of the United States, such as Texas and will be a significant problem in the years ahead. In 2006 sixty percent of the population believed there was already a physician shortage and sixty six percent agreed the problem would worsen over the next ten years. Currently the United States has a lower mid range physician to population level compared to many other countries. Korea for example, has the lowest physician to population level and Greece has the highest.


While there are multiple sources of information detailing the causes and cures for the problem we remain largely unaware of the impact this issue will have on us as consumers of health care services.


One fifth of the country’s population live in areas that have been designated as physician shortage areas. The lack of access to a Doctor has had dire effects on those who live in these areas. Many are unable to obtain timely Doctor’s office visits with wait times increasing significantly in direct correlation to the few physicians already burdensome patient load.


There is also less opportunity to explore preventative measures so that when the patients present themselves the outcomes tend to be poorer in nature. Furthermore, many of the rural community hospitals have had to close citing financial problems thereby exacerbating the scope of the problem.


Foresight was shortsighted? Yes indeed, adding to the ever increasing shortage, the American Medical Association as well as other medical groups in the 1990s were predicting that there would be a surplus of doctors. These predictions astoundingly resulted in many of the medical colleges instituting an enrollment freeze to the extent that there were virtually no increases in the numbers of enrolling students from 1980 to 2005. All the while our nation’s population sizes were experiencing an overall increase of nearly one third in size.


We are getting older across the nation. As the numbers of geriatric populations double in size by the year 2030, the specialized areas of medicine that serve these populations will feel the greatest impact of all. These targeted fields of practice will show the largest shortages as high as twenty five percent per 100,000 patients by the year 2020.


Why? Statistically, groups between the ages of 65 and 80 consume many more health care services than any other age group. In fact they utilize medical services at three times the rate of the younger folks. Additionally, doctor’s office calls show a marked increase for those over age sixty-five and to one study the actual visits rise 25% between ages 55 to 65 and then an additional 25%, for a total of 50% after age 75. The increase in patient visits and decrease in specialized practices may be one day known as the perfect storm in the medical community.


Doctors are not immune to aging either. While the baby boomers did a great job of supplying the populations that went into medicine, presently there are over 250,000 Doctors that are currently over the age of 55. As this baby boomer segment of the population begins to retire, it will add dramatically to the physician shortage, creating an alarming rate of attrition.
Older Primary care physicians are currently working under an ever increasing patient load because younger doctors are reluctant to become low paying general practitioners. Many are considering getting out of medicine altogether and no longer recommend Primary Care practice to younger associates. As a medical career, primary care practice promises to come complete with grueling work hours, burdensome patient load and almost nonexistent family time resulting in the perks being few and far between. Primary care physicians, at the present rate of attrition may very well become an extinct species over the next twenty years.


The American people, though they do not consciously think of it being related to an actual physician shortage are growing wearier everyday of having to wait months for doctors appointments or having to go to the Emergency Room during the night and weekends or during a holiday just to get help with many fairly minor issues. Statistics state that 70% of ER visits are actually not necessary at all.
Physician extenders are on the rise. As an answer to this growing problem many of the services that are considered physician extenders such as nursing professions and physicians assistants are rapidly ramping up services that can augment the rapidly increasing Primary Care physician deficit.


Telehealth Telemedicine is another viable answer coming to the forefront. An emerging technology in all areas of medicine is the steady insertion of telemedicine where it makes sense for the physician and the patient. Telemedicine curtails time and travel expenses for both the medical provider and the patient by utilizing technologies such as phones, faxes and the internet. Its use can dramatically enhance diagnostic time when using video conferencing systems in provider consultations and patient interviews. The visual aspect of the service can allow the physician to observe conditions, correlate symptoms and provide diagnosis without having to travel to remote locations or countries.


As in the internal medical industry institutes telemedicine in literally all areas of practice, they are also now implementing medical services online to consumers over the internet. These pioneers are assisting the consumer with medical questions, health maintenance and often even a prescription for medication without the consumer having to step foot in a doctor’s office at all. Voila! Shortly we will have instant gratification and convenience of medical treatment with the click of a mouse!


The medical community is continually looking for ways to impact the physician’s shortage and further exploration and enhancement of telemedicine as it relates to direct interaction with patients is imperative.
Telemedicine even widens the scope of the physicians practice providing doctors with a broader access to patients that are not within his personal geographical area of practice. Though they must pass rigorous examination even retired physicians now have a choice to continue to practice medicine in whatever capacity they choose without having to maintain a physical office or malpractice insurance.


Telemedicine is a win- win for both prospective patients and health care and I believe will rapidly become the preferred way to medical assistance in the not too distant future.