The Gulf Time Newspaper One of the finest business newspapers in the UAE brought to you by our professional writers and editors.
Add doctors to hospital beds and lab testing on the list of things that risk being in short supply as the coronavirus continues to spread in the US.
America has 2.61 physicians per 1,000 people, ranking it 26th out of 35 countries in an OECD database. Not all of these professionals are best suited to meet the current crisis due to age and overspecialisation. And even among doctors who are, there are bugs and barriers in US healthcare that make it harder for them to do their job. The predicament highlights structural problems in the status quo that are coming into sharper focus as rising Covid-19 case counts threaten to strain the system. All options need to be on the table to make sure people get the care they need without straining those who provide it.
How did we get here? The high cost of medical school is one culprit. Median debt for new doctors is $200,000 after four years of expensive post-graduate education, so it’s no wonder that American medical students lean towards narrow and high-paying specialties rather than primary care.
The average salary for orthopedists and plastic surgeons is nearly $500,000, as opposed to $230,000 for internal medicine. Doctors also gravitate toward cities, leaving chunks of the country under-served. Making things worse, a cap on federal funding of residency programs instituted in 1997 limited the pipeline of new doctors, contributing to a smaller population of physicians that are on the older side.
All healthcare workers are at risk of contracting the disease, reducing the numbers available to treat the sick, and older physicians will be at higher risk of becoming patients themselves. As Covid-19 spreads, hospitals are likely to need all hands on deck. While some specialists will be crucial, others will need to care for the sorts of patients they may not have seen since their training.
In the long run, the public sector needs to do more to boost the number of young generalists. Paying a substantial portion of tuition would go a long way, as would finding ways to close the pay gap for physicians who choose that path. This should be coupled with big subsidised boosts to residency programs and medical-school class sizes.
—Bloomberg
Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider