Opinion: Cure the doctor shortage by funding more residencies

G. Richard Olds

America is suffering from a critical shortage of doctors. Some 84 million Americans live in federally designated "Health Professional Shortage Areas" that lack an adequate number of primary care physicians, according to the latest federal data. That's a new record.

Young people -- and medical schools -- are trying to do their part to address the problem. Med school enrollment has increased nearly 30 percent since 2002. But all too often, med students struggle to find the residencies they need to complete their training after they graduate. 

Indeed, America's doctor shortage is the direct result of a shortage of medical residency slots. Consequently, to produce the doctors that America needs, public and private actors alike must commit more money to funding residencies.

This year, more than 37,000 people applied for 33,000 available residencies. That means that thousands of students who were smart enough to graduate from medical school have had to put their dreams of becoming a doctor on hold because there weren't enough spots for them to finish their training.

Further, less than half of those residencies were in family medicine, internal medicine, and pediatrics -- where the shortage is most acute. 

So not only are there lots of qualified would-be doctors on the sidelines -- those who get in the game are playing out of position.

Without enough residents today, we can't hope to replace the one in three doctors who will reach retirement age in the next decade.  

In fact, replacement alone won't be sufficient. Between now and 2030, the number of Americans over the age of 65 will surge 50 percent. These patients visit the doctor twice as often as those under 65. 

It's no wonder that the Association of American Medical Colleges projects that the United States will be short 49,000 primary care doctors by 2030. That figure is 14 percent higher than the organization estimated just last year.   

That shortage is just over a decade away. America's leaders must therefore take action now to address it. 

Congress can start by lifting the cap on the number of residency slots Medicare funds each year. That cap was imposed more than 20 years ago, when the U.S. population was roughly 50 million lower.

Medicare spends just over $10 billion on graduate medical education for physicians. Other government programs, including Medicaid, kick in another $6 billion. Those numbers need to go up. Training just one resident costs about $100,000 a year. 

(CAPTION): Nursing instructor Bonnie Malak, right, 55, of Troy, instructs student David Javorski, left, 29, of St. Clair Shores, how to properly cap a needle and dispose of it in "the sharps container" (upper-right, red container) after he administers a shot in the abdomen of Stan, Thursday. 
XXXXMacomb Community College is raising its profile and grabbing headlines recently with a new president and a couple of big projects, including a $14.5 million grant to construct a 30,000-square-foot health and science/technology building.Plans are also in the works for MCC, which serves 59,000 students annually, to host a Michigan State University program for first- and second-year medical students at its central campus in Clinton Township. Incoming president Dr. James Jacobs, the college’s first new president in 30 years, hopes to raise MCC’s visibility beyond state lines, especially given that much-touted plans last year for a four-year university in Macomb have fallen as flat as the economy.

Lawmakers can also move ahead with the Resident Physician Shortage Reduction Act of 2018, which would fund 15,000 residency positions over five years, beginning in 2019. The bill requires 50 percent of residencies to go to graduates serving in areas of practice where there are shortages. 

We can't wait any longer to tackle our growing doctor shortage. The right prescription is more residencies.

G. Richard Olds, M.D. is President of St. George's University.