Physician shortage and the future of medicine.

Dear Sir, I’m a third year college student contemplating postgraduate work in the medical field, either entering Physician Assistant (PA) school or medical school followed possibly by pediatric surgery, but I worry about the future of medicine due to politics and the government's increasing involvement in health care. Initially I was looking into attending PA School, but the projected shortage of physicians in the U.S. may reinforce my plans instead to attend Medical School. I often pause and reflect on the laborious and arduous future that lies ahead of me. In order to learn more about medicine and how physicians function, I have spent numerous hours shadowing physicians and observing surgeons and PAs in the operating room. Not only did I gain a better understanding of how physicians and surgeons function, but I also learned about the government's involvement in the medical field. Already in my own lifetime I have observed the government's intrusion in the medical field culminating with the Affordable Care Act (better known as Obamacare) and its implementation and this worries me.[1,2] I understand physicians are now experiencing lower compensation rates, more administrative duties, and less time nurturing the patient–doctor relationship, which is so important for good health outcomes. All of this makes me nervous for the future of medicine, especially considering the predicted shortage of 90,000 doctors by 2020.[2] I believe that the predicted manpower shortage of physicians is political, in part due to the government's involvement, and the U.S. Congress’ unwillingness to increase Medicare funding and their unwillingness to promote a climate conducive to the expansion of the number of residency spaces needed to provide adequate medical care in the future. There is a growing number of injustices forced upon medicine by the government's increased control and the concomitant gradual loss of physician autonomy. I’m not the only Pre-Med student worried about the future of Medicine. Many medical students are already thinking of going into fields such as vein specialty and plastic surgery, where there is less government involvement. Medicine is a noble profession, and those who practice medicine are able to serve and provide for others. Let us not forget that medicine started as an art before it became a science. The art of medicine was to aid our fellow human beings in sickness and alleviate their suffering, while being reminded men and women are not only physical but also spiritual beings, better ministered with compassion. I hope the venerable art and science of medicine can be saved before the government and politics destroy it. The implications of Medicaid, Medicare, coupled with decreased funding, have caused an increase in the number of patients that physicians see daily in their offices and the emergency room (ER). The result is that medicine has become more and more about increasing patient volume than about individual patient care. Due to increase load and the physician manpower shortage, nurses and PAs have to step in to fill the role of physicians. I also read with great interest the editorial, “The Lost Art of Inter-Provider Communication,” written by Mona Stecker.[3] She drives home many of these issues; inter-provider communication is important to better serve patients and improve efficiency. This becomes even more important as nurses and PAs step into physicians’ shoes in the near future. Sadly, while technology has tremendously advanced and communication has become more efficient, interaction with patients has paradoxically decreased. Tape recordings, computerized notes, and technological advances have displaced face-to-face communication, and the human touch and bedside manners for which physicians have been known in former times. This is an important topic that I will continue to explore as I consider my options prior entering the medical field. It will be interesting and telling to see how the government solves the problem of the predicted shortage of physicians, as well as observing how Nurse Practitioners (NPs) and PAs step up to fill the rank vacated by physicians. Mary-Kate Hunnicutt attends the University of Georgia as a Biology major with a Pre-Med emphasis. She is involved at UGA as a member of the Pre-PA and Pre-Med Club and a member of Phi Sigma Pi, the Honors Fraternity at UGA, as well as an Athletic Relations Committee member of UGA Hero's, an organization helping provide quality life care to children affected by HIV/AIDS.