Wednesday, September 19, 2012

Everything You Need to Know About a Doctor Shortage, Medical School Debt, and Physician Payment in a Few Easy Numbers

There has been a lot of discussion recently about an impending doctor shortage, the large amounts of debt medical students are saddled with, and whether physician reimbursements (Medicare specifically) are sufficiently high.  These issues all basically revolve around whether medicine remains an attractive occupation. While it's certainly possible to subject this question to extensive empirical analysis, a few simple numbers tell the story.

First, more than twice as many people apply to medical school as are admitted. In 2011, 43,919 people applied to US medical schools, and 19,230 were accepted and matriculated -- a ratio of nearly 2.3 applicants for every person admitted (who subsequently attended). This ratio has varied over time, but the long run average is greater than two. Don't just believe me -- the Association of American Medical Colleges -- the medical school trade association, publishes these statistics.

The fact that so many people want to become physicians (and so few do) over a long period of time is prima facie evidence that medicine is an attractive occupation.  If medical school debt is so crushing, or Medicare physician reimbursements so penurious, then why do so many people desperately try to get admitted to US medical schools?

Second, physicians from other countries want to come to the US, not the other way around. Currently approximately 26% of physicians practicing in the US were trained in other countries. Some of those people of course are US citizens, but the majority are (originally) foreign nationals. There is very little flow in the other direction.

Clearly medicine remains a very attractive occupation. That's not to say that we couldn't face problems when the Accountable Care Act extends health insurance coverage to over 30 million Americans, thereby expanding the demand for medical services. But any such shortage (if it occurs) will largely be due to restrictions on entry into the profession, not because medicine has become financially unattractive.



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