Author's Reply to Readers' Responses to “Help Wanted: More Doctors for the United States” (2005)

To the Editor,

Medicine is not an easy profession. But for many, and I hope most, physicians, medicine remains a highly rewarding life – professionally, spiritually, and financially.

Even with rising levels of medical student debt and relatively flat average physician incomes in recent years, a 2004 Association of American Medical Colleges (AAMC) study demonstrated that a career in medicine is still a “good investment” compared with other professions, and that physician incomes remain higher than most other occupations.[1]

Many of the challenges confronting today's doctors may not be what they expected when they chose medicine and must be addressed. However, the nation's medical schools and teaching hospitals also have a societal obligation to ensure that we have enough doctors to care for America's citizens.

The demographic trends of the aging baby boom generation and the current physician workforce's practice and retirement patterns point in an undeniable direction and are what compelled the AAMC to call for a 15% increase over the next 10 years in the number of physicians graduating from medical schools each year as well as an increase in the aggregate number of residency training positions. At the same time, we recommended that this growth be concentrated in areas of the country that have grown rapidly over the past 25 years, or are expected to grow rapidly in the future.[2]

Given the length of time it takes to educate and train a new physician, the impending shortage requires that we act now. Generating an oversupply of physicians is unlikely: AAMC projections show that the recommended increase in medical school graduates will produce about a 3% increase in the total physician supply by 2020.[3] By contrast, the number of Americans over the age of 65, the greatest users of physician services, will increase by more than 50% between 2000 and 2020, when Baby Boomers begin to reach their 70s in 2015.[4,5]

To ensure that our nation's system of medical education continues to meet the highest standards, the AAMC believes that the best way to increase our supply of physicians is to expand the capacity of the nation's accredited medical schools and to increase the number of residency training slots available for new graduates in teaching hospitals. At the same time, we recognize that more must be done to improve the healthcare system and physician satisfaction levels so that our most experienced doctors continue to practice.

We also recognize that more doctors alone will not satisfy the nation's burgeoning healthcare needs: the need for more nurses, physician assistants, and other health professionals is also great.

Fortunately, positive signs are on the horizon: Applications to medical school increased for the second year in a row in 2004[6]; many US medical schools have begun to increase their class sizes, and a recent Gallup poll found that the most common career advice that Americans give young adults is to “be a doctor.[7]”

One can only hope that the challenge of and commitment to helping others motivates more talented students to become doctors. Otherwise, all of us may be spending a lot of time in waiting rooms in the future.