My daughter is now in her second year of med school. From her vantage point, here are the problems we are going to be facing in the very near future:
An aging population with the healthcare needs that place a strain on government-paid insurances.
This strain is very real but is happening regardless of the ACA as the proverbial mouse moves down the snake. The population segment causing it, i.e. the baby boomers, will be primarily covered by Medicare and the solution to that, aside from continuing to cut reimbursements, is higher FICA taxes, as there is no other way for Medicare to pay for more people with the same amount of revenue.
Medical students declining to enter family practice or general medicine because of the lower reimbursement for their time.
Aspiring doctors desiring higher incomes have always eschewed general medicine in favor of the specialties. Family medicine, pediatrics, etc. have always been a "calling" more akin to teaching. General medicine can be covered more inexpensively and efficiently in other ways.
Additional people with "pay for everything free" insurance and no increase in the number of physicians to address their needs.
That is a function of the number of residency slots available in this country, as every medical school is full and turning out as many doctors as they can. Another solution is to increase the usage of NPs and PAs for routine care, which would allow the more highly trained physicians to focus on specialty care, where their training is needed, but that would require doctors to allow a reduction in their monopoly on patient care.
Longer waits to see a doctor because of their limited numbers. Conversely, non-MDs will be performing the tasks normally done by physicians, leaving the door open for misdiagnosis and missing some patients' problems.
Again, that is not wholly accurate, but any doctor shortages are a result of a bottleneck in physician education as there are no unfilled residency slots in this country. As for allowing NPs, PAs and other allied health professionals to deliver routine care, that is both a cost efficient way of delivering care and a way of reducing patient caseload. On a related note, can you cite any evidence that there is a higher rate of misdiagnosis of routine care by NPs and PAs than by MDs or DOs?
My daughter just attended a practice management class. Over and over, they are being advised to invest in a second business in order to pay their bills. They're being told that medicine will not be enough to make a decent living based on the amount of time and money they will put into it.
That has been the way for a long time, for many reasons. One of the most significant is that doctors are notoriously bad with money and generally horrific savers, coupled with the fact that they generally don't have any significant equity as a medical practice is not generally a valuable asset that can be liquidated at retirement. I work in finance and was also taught to diversify my assets and income stream, and I see that education for your daughter as a good thing, not a negative thing.
