Contract doctor numbers increase in US

Hospitals throughout the US are relying on freelance locum doctors to contend with a growing shortage of physicians. Indeed, the latest figures₁ show that in 2015 there was a shortage of 10,000 physicians and in 2016, 94 percent of health care facilities had relied on hiring contract doctors to help survive the shortage. This appears to be a growing trend as according to the Association of American Medical Colleges₁ the shortage will soar to 100,000 by 2030.

So why is there a shortage of physicians willing to take up full time positions? Well, there certainly has been much speculation and discussion as to why, with several key areas being raised.

One of the primary causes for the shortage is the substantial student loans required to pay for medical school and the influence this is having on chosen career paths.  A 2015 study₂ in the AMA Journal of Ethics looked at the affordability of medical school across the US and found that 73 percent of medical students will graduate with on average $180,000 or more of debt, which with interest can mean a repayment total of over $400,000. For young doctors who typically begin their careers in low-paying residency programs that generally last three to five years, this is a worrying prospect.

Another of the key reasons for physician shortages is that many doctors are actually choosing to go down the locum route instead of getting a full-time position at a hospital, as perceptions have changed. Not so long ago becoming a temporary physician at a hospital was not seen as a popular choice, as they were often considered less qualified. However, many now perceive that employing locums can actually elevate the overall quality at a hospital by giving full-time physicians time off and helping them avoid burnout.

There are of course the obvious benefits of working as a locum, which has led physicians to do freelance work instead of a full-time contract. These include getting paid more hourly, not having to wait for insurance reimbursement to get paid and making their own hours. For many saddled with their medical school debts, they are taking the opportunity to pay off their debt faster than they could with an entry-level job.

There is also the attraction of easily landing the jobs through a health care staffing firm who can offer the straightforward service that covers everything from housing to travel to medical malpractice insurance. As for hospitals, in the midst of a doctor shortage, to prevent them from having to turn patients away they are relying on physician staffing agencies to screen the doctors and fill the positions.

The demand for physicians, not to mention registered nurses, medical administrators and the bevy of other roles that are just as critical for healthcare as the doctors these jobs support, provides recruiters today with a significant set of challenges that will only continue to increase as the population continues to grow and age.

The Association of American Medical Colleges₁ report proposed evolving healthcare towards a more team-based approach to health care involving nurses, dentists, pharmacists and public health professionals. Training more doctors is certainly an option, as is encouraging young people to pursue a career in medicine through financial incentives.

What is clear is that tackling the problem, especially in the short-term, isn’t going to be easy. It will most likely necessitate the government to make changes to ensure the problem doesn’t continue to grow.

Sources:
₁ https://www.aamc.org/download/458082/data/2016_complexities_of_supply_and_demand_projections.pdf
₂ http://journalofethics.ama-assn.org/2015/02/oped1-1502.html

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