Too Few MDs

The paper this morning announced that the state I live in (Virginia) has too few doctors, then adds that ‘it is a nation-wide problem.’

Amid all the healthcare falderal over the last year and half this point seems to have been lost by the folks in Washington who seek to “lead” us (though, for the record, this blog has pointed this out several times over that same timer period). But it is worth repeating:

If the nation’s healthcare is too expensive, then the one sure way to reduce costs is to increase supply. Any other effort to reduce costs, that is, any efforts that do not include increasing ‘supply’ (the number of doctors, nurses and places to provide healthcare, which I will simply label as ‘beds’ for shorthand, though it includes more than strictly hospital beds) must include rationing, and will also fail.

The current plan, the one passed by Congress and signed by the President just a half year ago, includes no plan to increase the ‘production’ of doctors, nurses and beds.

Ergo, it will fail.

To produce doctors, nurses and beds, what is needed? Enlarged and expanded hospitals and clinics, expanded medical and nursing schools, and more students who want to enter medicine.

So, there needs to be some sort of incentive, some motivation to induce students to switch out of other career fields and into medicine. There are lots of ways to do that, but the most important would be to make it clear that when they become doctors and nurses they are going to be able to practice medicine the way they want, rather than the way a government bureaucrat tells them.

Unfortunately, making a doctor or a nurse takes a good deal of time. Doctors in particular must not only complete medical school, they must also complete an internship and a residency before they enter private practice. For certain specialists this can mean many years of effort. So, how do we fill the gap between today and when a new plan might start producing greater numbers of doctors and nurses? We recruit doctors and nurses from overseas. This already happens without a great deal of government support simply because doctors and nurses want to come to the US to work in our healthcare system which is both leading in technology and techniques and also is more free than most of the healthcare systems in the world. We simply need to be more aggressive in our recruiting.

These two things are needed to address the high costs and shortages of our current healthcare system: a short-term plan to recruit more doctors and nurses from overseas, and a long-term plan to expand the ‘production’ of doctors and nurses by our universities and teaching hospitals. Everything is going to produce other results, but not the desired ones.

(I will continue the discussion on jobs and the economy tomorrow.)