Where Have All The Doctors Gone? Read It and Weep

Read It and Weep, Where Have All the Doctors Gone? Daily Kos, Jan. 14, 2025. Ed.

The AARP Bulletin has a article this month by Howard Zucker that makes me want to tear something up and scream. It documents the bad trends in our the number of doctors in our nation and how they are used and treated. Short summary: our system is screwed and so are we, and it is only going to get worse, assuming no changes and there is little reason to expect any. Here is the link, although you may have to register: Where have all the doctors gone? Some key excerpts:

“The backbone of our health care system, private practice, is on the brink of collapse,” warns Clarel Antoine, M.D., professor of obstetrics and gynecology at New York City’s NYU Grossman School of Medicine.

“As a result, the nearly 70 million Americans on Medicare, many with chronic conditions, can expect longer waiting times for medical care.”

Why don’t we have enough doctors? In 1980, a U.S. government report concluded that American teaching hospitals were graduating too many medical students. It predicted a surplus of 70,000 physicians by 1990, an alarming statistic. In response, medical schools established what became a 25-year moratorium on increasing class size, enforced by the AAMC and the American Medical Association (AMA). Yet there was a significant flaw to that initial report: It failed to account for the nation’s rising population, which is now 110 million more than it was 45 years ago.

And how are they forced to use their time? In reporting this story, I spoke with dozens of physicians, the vast majority of whom vented their frustrations with the current state of medicine. But just as tellingly, almost all of them also refused to talk to me on the record, fearing that speaking out could cost them their jobs. Part of what’s driving this is the growing trend of private equity firms and corporations, such as CVS Health and Amazon, purchasing hospitals and private practices. One major medical group, with about 90,000 doctors in some 2,000 locations across the country, has spent billions of dollars acquiring physician-owned practices, home health centers and surgical centers.

This past April, the Physician Advocacy Institute reported that just shy of 80% of all doctors were employed by hospitals or corporations, up 200% in just over 10 years. Typically, when for-profit firms acquire practices, they approach these acquisitions utilizing a profit-based strategy. What does that look like? The doctors I spoke with off the record explained that corporate entities now govern their allotted time with patients, often allowing just 15 minutes per visit, a situation that isn’t healthy for either the doctor or the patient. “They control every aspect of a doctor’s professional life, and it’s all about the money,” one doctor told me...
https://www.dailykos.com/stories/2025/1/14/2296915/-Read-it-an-weep-where-have-all-the-doctors-gone