Wednesday, March 18, 2009

Doctor Shortage and Types of Doctors

I have been reading about the shortage of doctors in the United States. I started thinking about this subject when I was trying to find an obstetrician, then pediatrician and then again with a family doctor...still looking for the later. I would also like to point out that there is a shortage of Registered Nurses (RN) and Licensed Practicing Nurse (LPN). In addition to the Medical Doctor (MD) shortage there are even fewer Doctors of Osteopathic Medicine Doctors (DO) or Naturopathic Doctors (ND). This is unfortunate.

Here is some information I pulled from other websites.

The Shortage

Here are some statistics and background information on the medical world in general from an article in USAToday.

"The country needs to train 3,000 to 10,000 more physicians a year — up from the current 25,000 — to meet the growing medical needs of an aging, wealthy nation, the studies say. Because it takes 10 years to train a doctor, the nation will have a shortage of 85,000 to 200,000 doctors in 2020 unless action is taken soon."

"The nation now has about 800,000 active physicians, up from 500,000 20 years ago. They've been kept busy by a growing population and new procedures ranging from heart stents to liposuction."

"To become a physician, students spend four years in medical school (two years graduate school with two year in rotation). Graduates then spend three to seven years training as residents, usually treating patients under supervision at a hospital. Residents work long hours (80 hours per week) for $35,000 to $50,000 a year. Even doctors trained in other countries must serve medical residencies in the USA to practice here."

"Some medical policy specialists say the USA doesn't have too few doctors, just poor distribution of them.

"We have more and more physicians taking care of fewer and fewer patients," says Kevin Grumbach, chairman of family and community medicine at San Francisco General Hospital.

He says doctors gravitate to high-paying practices — such as sports medicine and total body scans — that serve the wealthy and well-insured at the expense of Medicare patients and others.

"It's wrong to think that we can produce more physicians and have them trickle down to where they are needed," says Grumbach, who favors a government-run, national health care system. "Investing billions of dollars to produce more doctors is a foolish way to spend money."

I appreciate the idea that a person should be able to choose where they want to work though, those doctors that choose to locate in "doctor scarce" rural or urban areas should get an "inkind" bonus. The inkind could be that the municipality or state helps the doctor locate and secure a medical building - preferably on a bus line.

and The Acronyms Associated with them

MD = Medicine Doctor

Recognized as a physician in all states

DO = Doctor of Osteopathic Medicine

Recognized as a physician in all states

ND = Naturopathic Doctor of Medicine

Recognized as a physician in Arizona. Considered a licensed medical practitioner in 16 states, the district of Columbia and five Canadian Provinces. There are two types of Naturopath; Naturopaths and Traditional Naturopaths. I think the issue of two types of Naturopaths is what caused not all states to adopt Naturopaths.

In these above mentioned jurisdictions, naturopathic doctors must pass comprehensive board exams set by the North American Board of Naturopathic Examiners (NABNE)[25] after having completed academic and clinical training at a college certified by the Council on Naturopathic Medical Education (CNME).[26] The letters ND usually designate a naturopathic doctor in jurisdictions where such a title is protected by law, although other designations exist. In unregulated jurisdictions, the ND title is not protected and may be used by any practitioner regardless of qualifications.

Just make sure your doctor has passed their board exams and

CMD = Chinese Medicine Doctor

CMD is not recognized as a physician without a MD or DO degree in the United States, though these doctors practice in over a hundred other countries. This is unfortunate because the CMD physicians education is a thousand (yes I said 1000) years old. They are well respected physicians in the rest of the world. The World Health Organisation uses CMD practitioners as physicians just as they would MDs and DOs. The U.S. has a tendency to be behind in medical science based on the many studies I have read, for example Chiropractic services took a long time to adapt in the U.S. and become registered. At one time going for a massage was considered a luxury, not a therapy as it is now viewed. A person who who went for a jog on purpose, with no destination, was considered a person who "has loss a few marbles." So, CMD not being recognized in the U.S. is not surprising.

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