Electronic communication could cause doc shortage to 'evaporate'

Electronic communication could help put an end to the perennial physician shortage problem in the U.S., according to new analysis published this month in the journal Health Affairs.

In fact, the physician shortage problem may be overestimated due to the increasing adoption of technology in healthcare, according to Linda Green, a professor of Business at the Columbia School of Business; Sergei Savi, an associate professor at the University of Pennsylvania's Wharton School; and Yina Lu, a doctoral student at Columbia's business school.

"We show that by implementing partial pooling of patients by two or three physicians and diverting as little as 20 percent of patient demand to nonphysician professionals or using electronic health record-enabled electronic communications, or both, most if not all of the projected primary care physician shortage could be eliminated," the authors say. "Given the trend toward larger physician practices, growth in patient-centered medical homes, team-based care and adoption of electronic health record systems encouraged by federal incentives, these operational enhancements seem entirely plausible, if not conservative."

The authors acknowledge that such trends could cause continuity of care problems, but simultaneously counter that argument by pointing out that EHR use means that one doctor can pick up where another left off without skipping a beat.

For the study, the authors ran a simulation that calculated patient panel sizes. Data was pulled from two 2012 surveys--the National Ambulatory Medical Care Survey and the Medical Expenditure Panel Survey--to determine average patient demand rates and appointment lengths.

"If we include the impact of diverting a fraction of patient appointments to nonphysician professionals, or of addressing some of the demand through electronic communication channels, the predicted physician shortage essentially evaporates," they say.

A study published in November in the Annals of Family Medicine concluded that the U.S. is poised to experience a shortfall of up to 52,000 primary care doctors by 2025. One of the main reasons for their findings? Lower compensation when compared to other medical fields.

However, a study published in Academic Medicine earlier in the year determined that primary care careers could indeed be economically viable for current medical school students who graduate with a median debt of about $160,000.

To learn more:
- here's the Health Affairs abstract