Survey contradicts doctor shortage claim

Texas Medical Center: Patients report having little trouble scheduling new appointments

A new Texas Medical Center national survey challenges the oftenrepeated prediction that the United States will face a dire physician shortage in coming years.

The fifth annual survey by the Medical Center’s Health Policy Institute

not only asked doctors in all 50 states about future shortages, but also polled thousands of consumers about what they were experiencing now. Both answers seem to contradict conventional wisdom.

While most doctors said they were indeed bracing for predicted shortages, more than half said they could not be sure such shortages are inevitable. Most patients said they have no trouble getting appointments with either primary care doctors or specialists.

“This is a crack in what has previously been a certainty of a physician shortage,” said Dr. Arthur “Tim” Garson, director of TMC’s Health Policy Institute which commissioned the survey.

“The Pulse of Consumers and Physicians: The 2019 Texas Medical Center Survey of the US and

Texas” asked 2,000 consumers and 750 doctors, both primary care physicians and specialists, a wide array of questions about the state of the nation’s health care.

The findings contrast with a host of other studies from the medical establishment, including an alarming estimate from the Association of American Medical Colleges which predicted the nation could be 121,000 physicians short by the next decade. In addition, many health experts have voiced concern about the current availability of doctors, especially in rural areas.

Texas is ranked 47th out of 50 states in having enough physicians to serve its population, according to the AAMC. The Texas Medical Board has reported that 24 Texas counties have only one physician.

But again, the new TMC survey, released Tuesday, found that its respondents’ experiences are more positive. Fewer than 1 in 5 patients

nationwide — both in rural and urban areas — reported having trouble scheduling a new appointment in the past 12 months.

“The best way to tell if we have a doctor shortage is by asking patients whether they can easily get an appointment,” said Garson, “For now, they overwhelmingly say, ‘yes.’”

Michael Dill, director of workforce studies at Association of American Medical Colleges, disagreed. He said the data collected by his group’s annual survey of 5,500 U.S. adults shows that in 2019, 25 million American adults could not get care when they needed it.

“Our data represents an actual inability for Americans to get care,” Dill said in a statement, “not those who have difficulty getting an appointment.”

Vivian Ho, a health economist at Rice University’s Baker School of Public Policy, was not especially surprised by the results of the Texas Medical Center survey. “I generally believe that statements about a looming physician shortage are overblown,” she said Monday.

“Nurse practitioners have long been capable of performing many physician tasks, but they have been restricted by state regulations that protect the physician population,” Ho said. “Modernizing regulations regarding scope of practice and tele-medicine would go a long way toward addressing any concern regarding a physician shortage.”

The sweeping survey tackled other issues as well, ranging from politics to physician salaries to curbing health care costs. Consumers ranked affordable health care as their most pressing issue.

Both consumers and physicians agreed that the best way to lower health care costs is for people to take better care of themselves. “This is new,” said Garson, who has headed the survey since its inception. “Forty percent of life expectancy is what we do to ourselves. It’s wonderful that patients get that.”

A majority of the respondents also said reducing the number of unnecessary or marginal tests and procedures insisted upon by patients or performed by doctors would bring down costs.

Nearly seven in 10 doctors, both primary care and specialists, said they wanted to be paid by salary rather than the current fee-for-service model by which they are paid for every service performed.