NCPA - National Center for Policy Analysis

Federal Policies Contributed to Doctor Shortage

July 17, 2003

Where did all the medical specialists go? Across the country, there is anecdotal evidence that anesthesiologists, radiologists and child psychiatrists are in short supply. Consumers are paying the price in higher fees, longer waits and sketchier care. By 2020, we will be short 150,000 specialists, according to Richard Cooper of the Health Policy Institute (Wisconsin).

Crippling high premiums for medical malpractice insurance have taken most of the blame for the doctor shortage, but an equally guilty party is the federal government's unsound method of allocating residency slots at medical schools, notes author Heidi Brown.

  • Congress has enormous influence over how many residency spots there are at each of the country's 126 medical schools and therefore over 73 percent of physicians entering the work force (the rest come from other countries).
  • It does this through its control of Medicare, which funds many of the residency programs and fellowships that doctors rely upon to get their specialty training.
  • In 1993, a new panel made a similar prediction that by 2000 there would be 165,000 excess specialists.
  • They figured that ascendant Health Maintenance Organizations (HMOs) would use more primary-care docs, not brain surgeons -- as a result, specialist residency spots began vanishing.

What the bureaucrats didn't foresee was the dizzying number of new specialized tests that require specialists to evaluate them.

Source: Heidi Brown, "The Doctor Is Out," Forbes, July 21, 2003.

For text


Browse more articles on Health Issues