The Next Endangered Species: Doctors

When President Nixon signed the Endangered Species Act in 1973, it is doubtful anyone contemplated the “Humanis doctoris.” But despite recent efforts to open new medical schools and increase the size of existing medical school classes, a severe physician shortage looms on the horizon.

In November 2008 the Association of American Medical Colleges looked into the supply of doctors and predicted a shortage of 125,000 physicians by 2025. While these shortages may be most pronounced in primary care, they cover the gamut of medical and surgical subspecialties. There simply are not enough doctors in the pipeline. Unfortunately, the so-called health-care-reform legislation that recently passed via reconciliation along party lines will only exacerbate this trend, with the corollary being increased wait times for appointments and the inevitable rationing of care.

Obamacare presumably puts more patients into the health-care system, so extra doctors will be needed to treat the additional infusion. As the demand for doctors peaks, Obamacare does little to increase the supply. In fact, it will have physicians running in the opposite direction. An IBD/TIPP poll conducted prior to enactment found that 45 percent of practicing physicians would consider leaving their practice or retiring prematurely if reform passed. A more recent Medicus physician survey of over 1,000 physicians reached a similar conclusion.

Obamacare will bring the dearth of physicians to disastrous new levels. No doubt they may become the next endangered species, at least in their current form: the brightest, best educated, best trained, and most dedicated. Despite living in an environment that has become ever more hostile since Medicare’s implementation in 1965, this resourceful species has somehow managed to teeter on. Physicians deserve credit for demonstrating unparalleled resilience in the face of an increasingly litigious and bureaucratic habitat dominated by predatory regulators and third-party administrators. All things considered, it is amazing physicians have survived this long. It is important to remember that despite their ability to heal and save lives, as mere mortals they can only tolerate so much. Remember, even the symbol of American preeminence, the bald eagle, has been in extremis.

Obamacare may very well be the proverbial last straw. To describe the new law as bad for physicians would be an understatement. It transfers more control of important health care decisions typically made between doctor and patient to faceless unaccountables in Washington, D.C. It creates roughly 159 new committees, agencies, and bureaucracies with virtually limitless power to dictate physician decisions. As a result, doctors will encounter increasing bureaucracy, paperwork, diminishing autonomy, and declining job satisfaction. They will be compelled to waste more time complying with regulations and, as a consequence, have less time to devote to patients and the practice of good medicine. Time constraints will force physicians to see more patents in less time to maintain their own standard of living. Sick people and the quality of care will suffer the most.

Obamacare has the potential to put physicians on a one way path to extinction. Don’t believe it? Then whatever happened to Tyrannosaurus rex?

— Jason D. Fodeman, M.D. is an internal-medicine resident at the University of Connecticut and a former graduate health-policy fellow at the Heritage Foundation.

Published on National Review Online: Critical Condition, September 22, 2010.

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