Doctor and Nurse Shortages Plague U.S.

The nation's struggles with physician and nurse shortages are evident as health care reform takes shape.

NPR reports on medical camps that try to recruit doctors to rural areas: "It was a Third World scene with an American setting. Hundreds of tired and desperate people crowded around an aid worker with a bullhorn, straining to hear the instructions and worried they might be left out. ... For the past 10 years, during late weekends in July, the fairgrounds in Wise [Va.] have been transformed into a mobile and makeshift field hospital providing free care for those in need. The 2009 Remote Area Medical (RAM) Expedition comes to the Virginia Appalachian mountains as Congress and President Obama wrestle with a health care overhaul. The event graphically illustrates gaps in the existing health care system." Patients came from 16 different states, with 30 percent making return visits. Fifty-one percent are uninsured, 40.3 percent are on Medicaid or Medicare and just 7.3 percent have employer or private insurance. "Fewer than 1 percent of patients have dental or vision insurance." Other stats: 26 percent are employed, 40.6 percent are unemployed, 4.7 percent are retired and 4.8 percent are children. NPR notes that "organizers paid about $250,000 out of pocket to run the event, and they provided an estimated $1.5 million worth of care" and have "eight more expeditions planned this year, from Virginia to California." 

"Medical, dental and vision help is often elusive for the 2,700 people seeking treatment. ... Just over half of the people attending this year have no insurance at all, according to a survey of the patients conducted by RAM. Forty-seven percent could be considered underinsured, given unaffordable copays or gaps in coverage provided by Medicare, Medicaid and conventional insurance plans. Only 11 patients have dental insurance, and just seven have vision coverage" (Berkes, 7/27).

ABC News' Political Punch blog reports that first lady Michelle Obama stressed the importance of primary care physicians while on a trip that focused on preventative care and wellness in health care reform to a community health center in rural Virginia: "Mrs. Obama participated in a ribbon-cutting ceremony at the Caroline Family Practice, a renovated grocery store thanks to a $1.3-million federal stimulus grant. Last month, she announced that $850 million in stimulus money was being released to help such clinics provide care nationwide. Overall, the president's economic stimulus program provides $2 billion for upgrading and expanding community health centers. Mrs. Obama said that money would expand primary care services to more than 2.8 million people, create jobs and address the shortage of primary care physicians" (Tobianski, 7/27).

Reuters reports on a particular shortage: "The U.S. is likely to face a severe shortage of heart surgeons in the next 10 years, say representatives from medical schools and thoracic surgeons' groups. Writing in the journal Circulation, Dr. Atul Grover of the Association of American Medical Colleges in Washington, DC and colleagues point out that the number of active cardiothoracic surgeons in the U.S. 'has fallen for the first time in 20 years.' More than half of today's cardiothoracic surgeons are older than 50 years, and more than 15 percent are between the ages of 65 and 74 years, the researchers note. Based on current population growth, aging, and patterns of health care use, the demand for cardiothoracic surgeons could rise by 46 percent by 2025, they predict, while the supply will likely fall by 21 percent over the same period as today's senior surgeons retire and newer surgeons increasingly opt for other specialties. ... Interest has been waning in what was historically a very competitive field: Every year from 2004 to 2007, there were more openings than applicants for spots in cardiothoracic residency programs" (7/27).

The Springfield Business Journal reports on shortages in the health care sector in Missouri: "According to the National Council of State Boards of Nursing, Missouri is experiencing a 9.5 percent shortage of registered nurses, although 70 percent of nursing schools in the Show-Me State have reported an increase in the number of qualified applicants. Nationally, though, the nursing shortage is expected to reach 500,000 by 2025, according to the New Jersey-based Robert Woods Johnson Foundation" (Wagner, 7/27).

The Baltimore Sun reports on an effort to accelerate nursing studies: "A $1.2 million grant will help Harford Community College expand its nursing program to include an accelerated 15-month course that offers evening, weekend and online classes. The 15-month course could prepare as many as 88 nurses by 2014 in less time than the college's traditional two-year program. The Health Services Review Cost Commission, an association of area hospitals, provided the grant to address the critical nursing shortage." The Sun notes: "As the nursing shortage continues, colleges are tailoring courses to mesh with the lives of their prospective students. Offering online courses and scheduling classes at nontraditional times may also attract more teachers in the program" (Hare, 7/28).