s******n
发帖数: 2279 | 1 AAMC Center for Workforce Studies
By News Staff
10/20/2010
As family medicine residency programs grapple with how to incorporate new
duty hour and other limits for physician-trainees, the Association of
American Medical Colleges, or AAMC, has released workforce projections that
reveal physician shortages will be even worse in the new health care reform
environment than previously anticipated.
In a Sept. 30 press release, the AAMC announced that it has revised its
earlier estimates of current and looming physician shortages; the new
figures are more than 50 percent greater than previous estimates. As a
result, the AAMC is calling on the U.S. Congress to support at least a 15
percent increase in residency training slots to lessen those shortages and
enhance access to care.
Prior to the passage of the Patient Protection and Affordable Care Act, "the
United States already was struggling with a critical physician shortage,
and the problem will only be exacerbated as 32 million Americans acquire
health care coverage and an additional 36 million people enter Medicare" in
the next decade, said the AAMC press release.
The updated findings (2-page PDF; About PDFs) from the AAMC Center for
Workforce Studies include the following:
•Between now and 2015, the year after all new health care reform
provisions take effect, the shortage of physicians across all specialties
will more than quadruple, from 13,700 to 62,900. The shortage in 2015 is
more than 58 percent greater than estimates before the passage of health
care reform.
•In the next decade, there will be a shortage of more than 45,000
primary care physicians and a shortage of more than 46,000 surgeons and
other medical specialists -- a total shortage of more than 91,000 physicians.
•In the next decade, the number of Americans older than age 65 is
expected to increase by 36 percent. During the same period, nearly one-third
of all physicians are expected to retire.
•Although the physician shortages will affect every segment of the U.S
. population, the most severe impact will be on the 20 percent of Americans
who live in rural or inner-city locations designated as health professional
shortage areas.
•Finally, although the number of medical students will continue to
increase -- by as many as 7,000 additional medical school graduates each
year during the next decade -- unless Congress acts now to increase the
number of residency training slots, "access to health care will be out of
reach for many Americans."
"Congress must lift the freeze on Medicare-supported residency positions,"
the AAMC emphasized. "Because all physicians must complete three or more
years of residency training after they receive an M.D. degree, Medicare must
continue paying for its share of training costs by supporting at least a 15
percent increase in GME (graduate medical education) positions, allowing
teaching hospitals to prepare another 4,000 physicians a year to meet the
needs of 2020 and beyond."
The AAFP has made similar calls to Congress, stating in its 2009 Workforce
Reform Policy that additional training positions for family physicians need
to be funded.
More recently, the AAFP has characterized new Common Program Requirements (
19-page PDF; About PDFs) approved by the Accreditation Council for Graduate
Medical Education as placing an added financial burden on many family
medicine residency programs -- especially smaller rural programs -- at a
time when the need for more primary care physicians has never been greater. | p***0
发帖数: 22 | 2 many hospitals are either closed or laying off the work forces ,including
physicians these days. Lately, I have seen more and more residents, esp,
fellows cann't find jobs anywhere. So, in long run, the future for physician
will be dim. | s******n
发帖数: 2279 | 3 供应和需求的矛盾吧，比如在北京上海的三甲医院，永远都是不缺医生的，而内地县城
医院呢？
美国老龄化社会的到来决定了医生的需求肯定是升高的，而非裔西裔的比例越来越大，
加之赤字越来越大，决定了低薪速成班培养医生会成为未来的趋势 | s******n
发帖数: 2279 | 4 现在是卡在住院医生名额这个瓶颈口了，医学院再怎么扩招也没用，
如果真能增加1万5，那就是皆大欢喜了，就看能不能有这个智慧和政治动机来解决经费
问题了，共和党总是停留在二战后美国强盛国力支撑下的生活方式，高薪医生高收入白
人老年病人舒适诊疗环境，根本上抵制搞全民医保和福利式OBAMA CARE，而民主党为了
黑人西裔的选票，但也不知道钱从哪里来，选举政治的效率决定了不会萧规曹随，而朝
令夕改使得美国的很多问题解决速度并不乐观 | d****y
发帖数: 2180 | 5 低薪速成班培养医生：NP， PA之类的会比较HOT
【在 s******n 的大作中提到】
: 供应和需求的矛盾吧，比如在北京上海的三甲医院，永远都是不缺医生的，而内地县城
: 医院呢？
: 美国老龄化社会的到来决定了医生的需求肯定是升高的，而非裔西裔的比例越来越大，
: 加之赤字越来越大，决定了低薪速成班培养医生会成为未来的趋势
| p***0
发帖数: 22 | 6 This is wrong. The total number of resideny do match the actual need, at
least. The current debate is how to increase AMG and kick out the IMGs. Thus
, you are seeing more medical schools are openning, around 8-10 in recent
yrs, but 住院医生名额 is constant, which will remain so for the future. The
ratio of physician/population is higher in US than China, or many other
countries. The reality in china is that, medical graduate cann't find job
either, even in county hospitals. There are too many subspecialists in US
currently,even primary care jobs become scarce in most of the major cities.
You would realize it if you work in hospital. I don't see any shortages at
all for all those yrs, but on the contrary, the hospital patients census are
downing in most of the areas. In addition, most of the doctors are
postponing their retirement as general people are healthier than previous
generation, and it is common to see someone aged 70-80s are still fully
functioning in hsopitals.
【在 s******n 的大作中提到】
: 现在是卡在住院医生名额这个瓶颈口了，医学院再怎么扩招也没用，
: 如果真能增加1万5，那就是皆大欢喜了，就看能不能有这个智慧和政治动机来解决经费
: 问题了，共和党总是停留在二战后美国强盛国力支撑下的生活方式，高薪医生高收入白
: 人老年病人舒适诊疗环境，根本上抵制搞全民医保和福利式OBAMA CARE，而民主党为了
: 黑人西裔的选票，但也不知道钱从哪里来，选举政治的效率决定了不会萧规曹随，而朝
: 令夕改使得美国的很多问题解决速度并不乐观
| s******n
发帖数: 2279 | 7 你用PHYSICIAN SHORTAGE搜索下，你会看到整体市场社会对医生需求是多还是少,只是
一个点得看，有失偏颇
美国的医疗教育体系是精英教育，不是社会福利提供者职业教育，美国价值体系是给有
工作有医保的人看病，同时这样的患者群也能维持医生的高收入，而昂贵的医学院费用
又JUSTIFY了这样的高收入，所以从医学院-医生-社会，都陷入了高支出高收入的恶性
循环，最后买单的社会就只能找赤字要钱，所以美国医疗开支占GDP比例在发达国家遥
遥领先，整体国民健康水平却只排中流。美国医学界叫医师短缺，增加住院医生名额，
当然是为解决AMG扩招后的后续培训问题，只是这事能成，FMG还有点希望，否则以目前
这种形式发展，能有FMG找到位置就是烧香了。
各国医师人口比例，美国其他数据算下来是排第32位左右
http://www.nationmaster.com/graph/hea_pra_phy-health-practising-physicians
http://bigthink.com/ideas/21237
Thus
The
.
are
【在 p***0 的大作中提到】
: This is wrong. The total number of resideny do match the actual need, at
: least. The current debate is how to increase AMG and kick out the IMGs. Thus
: , you are seeing more medical schools are openning, around 8-10 in recent
: yrs, but 住院医生名额 is constant, which will remain so for the future. The
: ratio of physician/population is higher in US than China, or many other
: countries. The reality in china is that, medical graduate cann't find job
: either, even in county hospitals. There are too many subspecialists in US
: currently,even primary care jobs become scarce in most of the major cities.
: You would realize it if you work in hospital. I don't see any shortages at
: all for all those yrs, but on the contrary, the hospital patients census are
| s******n
发帖数: 2279 | | m********4
发帖数: 607 | 9 我喜欢这样有理性讨论的帖子。
我没有什么高深的理论，但是，我分享我的所见，来说明现在美国的就业和经济形势是
否应该引起我们的注意？
我的美国老板太太，做了十五年的主妇，今年重新了返回职场。
我们楼下的实验室，上月雇用了一个看上去有60岁的女士。 | b****d
发帖数: 240 | 10 I totally agree with your assessment. Because the government will reduce reimbursement rate to save money, many doctors will have to work harder to make the same amount of money. As a result, clinics or hospitals would want to keep staffing low. And many old doctors will have to postpone their retirement.
It is getting TOUGHER each year. The early, the better. Do NOT drag your feet. Hop on the bandwagon NOW or never!
Thus
The
.
are
【在 p***0 的大作中提到】
: This is wrong. The total number of resideny do match the actual need, at
: least. The current debate is how to increase AMG and kick out the IMGs. Thus
: , you are seeing more medical schools are openning, around 8-10 in recent
: yrs, but 住院医生名额 is constant, which will remain so for the future. The
: ratio of physician/population is higher in US than China, or many other
: countries. The reality in china is that, medical graduate cann't find job
: either, even in county hospitals. There are too many subspecialists in US
: currently,even primary care jobs become scarce in most of the major cities.
: You would realize it if you work in hospital. I don't see any shortages at
: all for all those yrs, but on the contrary, the hospital patients census are
| k********n
发帖数: 756 | 11 "hop on the bandwagon" refers to herd instinct by which people follow others
regardless of the underlying evidence.
It is your dear maddoc, the echelon of the CMG, that probably wants everyone
to hop on the bandwagon.
reimbursement rate to save money, many doctors will have to work harder to
make the same amount of money. As a result, clinics or hospitals would want
to keep staffing low. And many old doctors will have to postpone their
retirement.
feet. Hop on the bandwagon NOW or never!
【在 b****d 的大作中提到】
: I totally agree with your assessment. Because the government will reduce reimbursement rate to save money, many doctors will have to work harder to make the same amount of money. As a result, clinics or hospitals would want to keep staffing low. And many old doctors will have to postpone their retirement.
: It is getting TOUGHER each year. The early, the better. Do NOT drag your feet. Hop on the bandwagon NOW or never!
:
: Thus
: The
: .
: are
|
|
