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A major expansion is underway at the nation’s medical schools that will sharply increase the number of new physicians entering the workforce over the next decade to care for an ageing baby boom generation.But critics say the move could backfire since medical schools are still channeling too many young doctors into highly paid specialties instead of primary care, which will exacerbate the problem of rising health care costs.
The Association of American Medical Colleges (AAMC) unveiled a new survey Thursday showing the number of students entering the nation’s 137 accredited medical schools will surge nearly 30 per cent from 2002 levels to 21,376 in 2016, meeting a goal set in 2006 when it was widely believed an ageing population would require far more physicians. About 19,638 first-year students will enter medical school this fall, up from 16,488 in 2002.
But the campaign to increase the number of practicing physicians, which has been spearheaded by the AAMC, has come under fire in recent years on two fronts. Health care reformers say the increased enrollment has not addressed the ongoing shortage of primary care physicians, especially in poor and rural areas, which will only grow worse when 30 million previously uninsured patients seek compensated care after 2014 because of the Affordable Care Act.
Meanwhile, cost-control advocates fret that the continuing migration of too many young physicians into highly paid specialties is contributing to the crisis in Medicare financing, which has been driven in part by overuse of expensive procedures. The AAMC projection assumes ageing baby boomers, like their parents, will become more dependent on the specialists who treat heart disease, diabetes, cancer and other chronic conditions that become more prevalent as people age.
Officials at AAMC say they have taken both factors into account in making the projections that led to the major increase in medical school slots. A dozen new medical schools have opened in the U.S. since 2002, including four in Florida, and seven more have either applied or plan to apply for accreditation.
“If you’re less than 50 years old, the majority of your visits are to primary care physicians, but after you turn 65, the majority of visits are to specialists,” said Atul Grover, a physician and chief of public policy at AAMC. “With the over-65 population growing rapidly, we’re also going to have a shortage of specialists.”
AAMC, which tracks medical professionals for the first seven years after they finish school, estimates about a third of newly-minted doctors go into some form of primary care, either internal medicine, pediatrics or family practice. But researchers at the centre for Studying Health System Change (CSHSC) peg the total at closer to 20 per cent since many internal medicine trainees eventually take up a specialty instead of remaining in general practice.