Why American Doctors Are Quitting

As the US heads inexorably towards a doctor shortage of catastrophic proportions, the last thing the country can afford is for experienced and established physicians to quit their jobs early. However, NBC News have reported that this is exactly what is happening.

Limited residencies, increased desirability of competing jobs, and suffocating bureaucracy have combined to drive compassionate doctors into early retirement, while at the same time ensuring that fewer young people enter the medical profession. Here are a few reasons why this is happening:

Competition from STEM Jobs

The problem starts with competition. With the USA entranced by a fever of innovation, jobs in Science, Technology, Engineering, and Math (so-called STEM jobs) have gained increased appeal and frequently pull down high wages.

Given the catastrophically high cost of medical school, many young doctors would prefer to study for four years to become an engineer than eight years plus to become a doctor. Fewer new doctors entering the profession puts more pressure on older physicians, who may be driven to leave the understaffed clinic in search of a better work life balance in a scientific or technological field where their medical training will be put to lucrative use.

Lack of Residencies for Graduating Students

For those students who do still choose to attend medical school, this by no means guarantees that they will go on to become doctors. Medicaid caps on subsidized residency programs in teaching hospitals mean that there are far fewer available residencies than there are graduating MDs.

This “bottleneck” means that every year, there are thousands of people who have the drive, the work ethic and the intelligence to pass medical school (not to mention the fortitude to acquire six figures worth of loans) but who are kept out from completing their training and becoming fully fledged physicians. At a time when the US desperately needs more doctors, this is a point in the funnel that is in most urgent need of mixing.

Doctors Want to Work with Patients, Not Forms

Established physicians who have successfully completed every stage of their training and gone on to have distinguished careers are also quitting long before their retirement age. Technological changes are one driving force behind this.

Electronic Health Records (EHRs) have for the most part replaced pen & paper patient records, but the upgrade has come with its fair share of glitches which often restrict doctors from being able to efficiently do their jobs.

Doctors report spending more time dealing with paperwork and insurance companies than with their actual patients. For someone who entered the medical profession in order to work with communities and help people, it can be extremely disheartening to end up feeling more like a bureaucrat than a healer.

“It has gotten worse for all of us, unfortunately — whether you work in the hospital or in the outpatient setting,” Dr Nicole Swiner told NBC News. “We are burdened more by non medical business or insurance professionals without any medical training. It’s disheartening. ​I have transitioned to more part-time clinical work [so as to focus more on] speaking, writing and consulting.”

Doctors and medical students alike experience shocking rates of depression, with up to 43.2% of resident clinicians experiencing depressive symptoms. Given this plethora of pressures, is it really surprising that medical professionals are searching for alternatives?

The US cannot afford to keep hemorrhaging medical professionals. At this rate, as the Association of American Medical Colleges (AAMC) grimly predicts, we will be short by as many as 120,000 physicians by 2030. We depend on doctors to heal us. But now the medical industry itself is sick. It’s time for our corporations, institutions and legislators to urgently find a cure.

What’s Causing Britain’s NHS Winter Crisis?

Recent BBC footage from the Royal Blackburn Hospital shows patients on trolleys clogging corridors, busy staff wiping sweat from their foreheads, and grateful patients hugging exhausted nurses and doctors.

One man said he’d been “queueing for five hours. It’s not what you expect from a country like ours, is it?”

A doctor admitted he hadn’t seen anything like it in his 26 years in the NHS.   

Britain’s NHS Is Facing an Unprecedented Winter Crisis

Winter pressures on the service have led to NHS England cancelling all non-urgent operations in January – resulting in around 55,000 procedures being delayed. Routine outpatient appointments have also been cancelled.

Hospitals are supposed to have no more than 85% of their beds full at any time, but some hospitals have reached 98% or even 99.9% capacity.

In the House of Commons, Labour MP Tracy Brabin described how one of her constituents had taken photos of people sleeping on hospital floors. Brabin said, “There were poorly people in chairs waiting for hours, not being given a bed or trolley.”

But what issues could be causing the NHS winter crisis, why are Britain’s hospitals so overstretched and why do things seem worse than in previous years? Four of the main factors are listed below:

Bed Blocking and the Social Care Crisis

An aging population, coupled with enormous government cuts to the social care budget, has led to the issue of ‘bed blocking’. Hospitals are often unable to discharge elderly or vulnerable patients because there are insufficient resources to care for them in the community.

Bed blocking has the knock-on effect of ambulance staff having to queue with their patients in corridors while waiting for beds to be freed up. This becomes especially acute in winter as demand for medical services surges.

Last year, Dr Taj Hassan, president of the Royal College for Emergency Medicine, told Radio Four’s Today programme, “There is an urgent need to address the patients who are fit to be discharged from hospital, which in some systems is running between 10 and 20%.”

There are also less beds to go round. According to the YouTube channel NHS Doc, there were 197,000 NHS beds in 1987, but by 2015 this number had dropped to 130,000, despite an increasing – and aging – population.

Unnecessary Trips to A&E and a Surge in Winter Illnesses

The pressure on hospitals is compounded by people coming to A&E with issues that could be dealt with by their GP or by phoning the NHS 111 hotline. This winter seems especially bad for flu-type infections. NHS England stated the service “has been under sustained pressure recently because of high levels of respiratory illness, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&E.”

Government Underfunding of the NHS

According to NHS Doc, demand for NHS services is rising at around 5% per year while costs are increasing at 7%. Funding, however, is only increasing at around 1.2% per annum in real terms, with a funding shortfall of £20 billion predicted by 2020.

In an interview with Channel 4 News, one junior doctor said, “This is the tightest squeeze on the NHS budget in its history. We have 15,000 fewer hospital beds; we’ve got £6 billion out of social care. It’s a crisis created by this government, which must now be held to account.”  

NHS Understaffing

In 2017, data from NHS Digital showed there were 86,000 vacant posts in NHS England, a rise of 15.8% on the previous year and the highest number on record.

This partly seems to be due to the stress of working in an underfunded, overstretched service. One junior doctor told The Guardian newspaper, “On my ward, the nursing vacancies now top 30%. The trust simply can’t find anyone to fill them.”

“For doctors, it’s little better. All our rotas are littered with gaps. When I’m starting a night shift, I’m frequently handed another doctor’s on-call bleeper. Now the nurses will page me for twice as many patients.”

Conclusion: What Is Causing Britain’s NHS Winter Crisis?

The NHS winter crisis seems to be the result of an unusually high level of winter health problems exacerbating long-term issues in the Health Service, namely underfunding, understaffing, bed blocking and the public making unnecessary A&E visits.

Many feel the NHS is now under the heaviest pressure in its history. Dr Taj Hassan said, “We are seeing conditions that people have not experienced in their working lives.”

Why The World Urgently Needs You to Become a Doctor

An aging population globally has left countries from the USA to China desperately short of medical professionals. As older doctors retire and too few young people enter medical school, the situation gets worse every year.

TechCrunch, citing a recent study by the American Association of Medical Colleges, reports that by 2025 the US could be lacking as many as 35,600 primary care physicians. Globally speaking, we’re already short 7.2 million healthcare workers with that number expected to rise to almost 13 million within the next two decades.

As this video from the AAMC puts it, because of how long it takes to train a doctor, a 2025 problem is actually a 2015 problem. And guess what: it’s almost 2018 and we’re still nowhere close to a solution. But there is hope.

If you have ambitions of becoming a doctor, you’re not only setting yourself up for a rewarding career; you’re also helping to make an important difference in the world. In this article we’ll look briefly at how this situation came about, and explore what we can do to fix it.

How Did We Get Here?

Basically, we’re all getting older! Right now, there are already 46 million Americans aged 65 and above. By 2060, this number is expected to double, meaning that almost one quarter of Americans will be over 65. Japan is already there.

In China, the demographics are more complicated with factors like the one child policy putting massive strain on people of working age. With just 189,000 doctors [source] in the entire country of almost 1.4 billion people, China is in even worse shape than the US.

Government policy has also played a role. In 1997, the United States Congress imposed caps on Medicare which have drastically restricted the ability of teaching hospitals to take on new residents. The AAMC says budget caps and related resident limits are “impeding teaching hospitals’ educational mission.”

This combination of an aging population and a lack of medical residents is a 1-2 punch. The world needs more doctors than ever before, while at the same time governments like the US make it harder for young people to get educated and become physicians. Clearly, something needs to change.

What Can We Do About It?

While we can use our votes to try and guide government policy, there’s nothing any of us can do about the global aging population – that’s a reality that the younger generation are going to have to live with.

What you can do about it is to become a doctor and make yourself a living part of the solution. Today’s doctors are armed with the best medicines and medical technologies in history. Ironically, this is one of the reasons why an aging population was able to occur in the first place! It’s also the only way to effectively solve this problem.

Advances in Technology Have Helped Cause This Problem. They Can Also Help Solve It

Medicine helps people live longer, which in turn creates an imbalance where there are many elderly people requiring medical care, but not enough young doctors to provide it.

Advances in medical technology are also making their way into education. The internet is a great leveler – anyone can now go online and watch lectures from some of the finest professors in the world (check out the Future Doc House youtube channel!) Because of this we’re moving closer to a world where anyone with the motivation and talent to become a doctor has access to the resources they need in order to do so.

stethoscope wallpaper

Picture courtesy of Freepik

Medical Education Should Be Fun – Right Now It’s Not.

There are many heavy, tragic and painful aspects to being a doctor. You deal with people at their worst, and will not be able to cure everyone who walks into your clinic. On the other hand, there’s also a real joy associated with the practice of medicine.

The best doctors – and the best medical students – enter the profession out of a passion to help others, and an insatiable curiosity to figure out the cures and solutions to complex problems.

Those medical students who drop out and never make it as doctors do not fail because they are not academically up to standard – that’s almost never the case. They quit because medical school is a long, arduous and tedious process.

Many burn out, others get put off by the mammoth amounts of paperwork demanded by governments and insurance companies. Others are simply denied residential spots due to government policy. The situation is tough, but technology is already helping.

How Innovations are Helping to Solve the Global Doctor Shortage

During my time as a student I frequently traveled, and spent several semesters abroad experiencing medical school in different countries. From my time in the USA and Europe, I learned first hand the challenges faced by medical students and the gaps in the education process which need to be addressed.

One of the things I saw lacking was an easy, fun and engaging tool to practice medical knowledge in a way that directly prepares students for licensure exams like the USMLE in the USA and the MRCP in the United Kingdom. Recently, new technology has started to address this. One of the tools I’m personally involved in is QUPI.

QUPI is a medical education startup founded by entrepreneurs from the UK, USA and Poland. It aims to solve this problem by providing a fun and efficient study tool for medical students, particularly for those in their first few years of study.  

An online question bank with over 10,000 questions covering the 12 disciplines medical students focus on, QUPI uses a clean interface and the principles of gamification to make their study tool as compelling as a videogame or social media platform.

They’re also working on a mobile app which will let students practice their medical knowledge on the go – imagine getting in an essential 5 minutes of microbiology study while waiting for the bus or standing in the queue at Starbucks! You can learn more about it at QUPI.com

With tools like this, as well as the abundance of invaluable education resources and lectures available online, now is the best possible time for you to become a doctor. And if you have the desire to embark on a medical career, then the world has never needed you more!

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