The U.S. healthcare system stands at a precarious crossroads.?
Medical advancements are at record heights. They offer hope and improve the quality of life for millions. We have technologies to help us be more efficient and streamline our health data. However, we also face a serious physician shortage that will worsen if we don't act.
The Association of American Medical Colleges (AAMC) predicts a shortfall of 37,800 and 124,000 physicians across primary and specialty care over the next 12 years.?
By 2034, we could see a shortage of:
- Primary care physicians. A loss of between 17,8000 and 48,000 primary care physicians.
- Non-primary care physicians. A loss of between 21,000 and 77,100 non-primary care physicians.
Why Do We Have a Doctor Shortage?
The following complex social, economic, and educational factors have contributed to the physician shortage:
- An aging patient population. By 2030, all Baby Boomers in the US will be 65 or older. Many will need more healthcare than there will be doctors available.
- An aging physician population. A record number of physicians are nearing retirement age. In 2021, 46.7% of doctors were over 55 years old. Another 40% will be 65 within the next ten years. Some doctors might delay retirement because of uncertain economic conditions and high healthcare costs.?
- Geographic disparities. There are big differences between healthcare in different areas. Many rural areas in America don't have enough doctors, especially primary care physicians. This means people in rural areas must travel far to see a doctor or wait a long time.?
- Student loan debt. The cost of medical education can be too much for new graduates. According to the AAMC, the average student loan debt is around $207,000, not counting undergraduate college expenses. Tuition has gone up by 3% to 4% each year for the past 10 years. This affects career choices and where people work. Many graduates choose specialties in big cities where they can make more money. This makes the shortage of primary care doctors even worse.?
- Physician burnout.?Physicians are experiencing burnout due to overwhelming administrative tasks, high costs, and long hours. A survey found that 63% of physicians and nurses in the US reported moderate or significant burnout. The COVID-19 pandemic has had a profound impact on the healthcare system, leading to over 230,000 clinical workers leaving in 2021. This has resulted in more physicians retiring early, working part-time, or choosing not to practice, worsening workforce issues.
Healthcare organizations are making systemic changes to reduce administrative burdens on providers through telehealth to address this. These changes are necessary to alleviate the additional pressure caused by demographic shifts within the healthcare system.
Using Telehealth to Improve Public Health?
Our book, Telehealth Success: How to Thrive in the New Age of Remote Care, outlines burnout issues and how telehealth can address the physician shortage. Telehealth is often misunderstood as just video doctor visits for basic urgent care, but it improves many other care delivery aspects. It makes things more efficient and improves communication for both doctors and patients.?
Telehealth provides the following benefits:
- Enhanced efficiency.?Telehealth can effectively deliver routine consultations, follow-up care, and mental health therapy. This frees up physicians' time for complex cases or optimizing workflows. Automating tasks reduces the documentation burden. Many telemedicine platforms seamlessly integrate with EHR systems. This helps patients and physicians get the most out of virtual visits.
- Fewer in-office visits. Telehealth also reduces the need for in-person visits and emergency department visits. According to the 2022 J.D. Power Telehealth Satisfaction Study, 80% of people prefer telehealth for prescription refills, 72% for reviewing medication options, 71% for discussing test results, and 57% for mental health visits.
- Value-added time. Telehealth can reduce the non-value-added time or tasks that don't improve patient care or interaction with patients. According to a recent study in the Journal of the American Board of Family Medicine, non-value-added care makes physicians feel rushed and stressed, degrading the patients' and physicians' experience. Converting potential no-shows to telehealth appointments, when appropriate, aids in efficiency and allows no loss of reimbursement.?
- Prevent readmissions. Telehealth lets you connect with your patients conveniently and instantly. This improves care and helps catch problems early. In a 2023 report by Sage Growth Partners, over 52% of clinicians said virtual healthcare helps them give better treatment.
- More coverage.?Telehealth allows physicians to see more patients without needing as many staff members. It also helps the staff on-site by giving them access to specialist consultation, which improves their shifts. Telehealth also gives doctors more flexibility in their schedules. For example, doctors close to retiring or with physical disabilities can now work from home and still care for patients.
- More access. Telehealth can help overcome the distance problems in underserved communities. It allows patients in these areas to connect with specialists easily, get consultations quickly, and manage their chronic conditions and treatment plans. For instance, a primary care doctor and a physical therapist can collaborate through telehealth to create a coordinated care plan for a patient in a rural area. The absence of distance problems means more doctors can work from various locations.
- Improve interoperability. Some telehealth platforms like doxy.me can connect with EHR systems, enabling enhanced workflows and seamless access to patient records across different providers.?
- Reduced costs.?Telehealth saves money. It eliminates travel costs, reduces administrative overhead, and allows remote patient monitoring. This can benefit both healthcare systems and patients.
- Stronger patient-doctor relationships.?Telehealth centers patients in their healthcare journey. Secure portals provide 24/7 access to medical records and educational resources and a convenient way to communicate with care teams. This empowers patients, improves self-management, and enhances the patient-provider relationship. Connecting directly with patients over telehealth without distractions can make physicians feel more connected to patients.
Empowering Telehealth through Policy
Congress introduced the Resident Physician Shortage Reduction Act of 2023 to address the physician shortage. This bill increases the number of Medicare-funded residency positions by 14,000. Although it doesn’t specifically provide initiatives to bolster telehealth, The Safer Communities Act does.?
The Safer Communities Act provides:
- Implementation guidance. Comprehensive guidance for states to implement telehealth.
- Infrastructure requirements. Clear guidelines on the technology infrastructure doctors need to deliver telehealth services effectively.
- Performance measurement. Metrics track the effectiveness of telehealth programs and enable states to monitor progress and identify areas for improvement.
- Reimbursement. Fair and transparent reimbursement rates for telehealth services.?
To drive wider adoption and success with use of telehealth, the Centers for Medicare & Medicaid Services will continue covering telehealth services in 2024, and the Biden administration also earmarked nearly $45 million of its FY 2024 budget for telehealth services.?
Telehealth cannot solve all the problems that burden the workforce and contribute to physician burnout. However, it can indirectly improve efficiencies access, and make patient care more targeted. These improvements can improve healthcare and give physicians more time to do things they enjoy about medicine, like spending time with patients. Surprisingly, using technology properly can bring us back to the human relationship in healthcare.
