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Did you know that according to the Bureau of Labor Statistics and the Medical Board of California, there are only 3400 psychiatrists in California with a population close to 40 million? That’s one psychiatrist per 11,000 people. Yet suicide is the second leading cause of death for teens, fourth leading cause of death for women between 35-55 and the 11th leading cause of death overall.
While this kind of supply and demand may seem like a winning formula for job security, it is problematic when lives are at stake—patients and physicians.
According to the AMA, in the entire US, there are only 740k licensed physicians. Many of us work more hours than we want or need to, simply to meet the basic demands of our community hospitals. In fact, most physicians work more than 50 hrs per week—this is after residency. Twenty five percent work more than 60 hrs. Each Physician has on average 3k patient-contacts per year. And we’re burning out.
We want need more physicians. We don’t like rushing you out of the door or making you wait two months for an appt, or triple booking patients during our lunch. We hate it as much you do. Many physicians are barely holding on as the system adds more to their daily duties yet offers no long term solutions that will bring relief.
Would it be surprising to know that we want more physicians but we do not determine that?
The number of physicians made per year is tightly controlled as it is linked to Medicare funding.
Congress decides how many psychiatrists there will be in 2020. They determine the exact number of residency positions—these are needed for an MD/DO to become licensed and board certified. We must go through a 3-11 year hospital based residency. In exchange for the Medicare dollars, we offer 80hrs a week of hospital work for those years. We cannot license with any medical board without completing the first year (internship). The additional years are needed to qualify to take our specialty board certification exams.
In essence, an MD/DO is completely useless clinically without a secured residency position. Last year over 1000 US medical school grads were left without a residency position.
Why? Congress hasn’t done its part.
Medical schools have increased their class sizes by 22% in the last decade to meet the demand of an aging population and increase in access due to the ACA.
But Congress has only allowed for a 3% increase per year of residency positions, i.e the number of doctors that will actually be able to work.
So every year, we produce over 1000 Med school grads who can’t go on to practice. This leaves eager, optomistic medical students with huge debt and the inability to use their degrees to practice medicine.
Yet, everyday we hear of a doctor shortage.
For the second time, a congressional act has been introduced to increase residency positions through 2033.
Without this, Americans will have fewer and fewer doctors left to see or the time to get to seeing one will continue to increase.
Patients will continue to be directed toward non-physician “providers” first (seen as less costly than making more physicians).
And even the diehard among us left standing will eventually burnout.
Please consider reaching out to your politician and sharing. The goal is to protect quality healthcare access in the US.