AMA Urges Legislative Action to Combat Growing Physician Shortage

An increasingly bureaucratic healthcare system and the unsustainable Medicare payment program are just two of the issues causing physicians to feel powerless and are pushing burnout to levels never before seen, said Jesse M. Ehrenfeld, MD, MPH, president of the American Medical Association (AMA), during a press conference Wednesday to highlight steps to stabilize the physician workforce.

"Physicians everywhere — across every state and specialty — continue to carry tremendous burdens that have us frustrated, burned out, abandoning hope," and are prompting some to leave the profession, he said.

According to Ehrenfeld, two thirds of doctors experienced burnout during the pandemic, the highest level of burnout ever recorded by the AMA. Unfortunately, doctors are often reluctant to seek help. "Four in 10 physicians in a recent Medscape survey said they have not sought mental health treatment because they worry about their medical board or employer finding out and potential repercussions," he said.

Physicians are navigating a radically different healthcare landscape after the pandemic and the rollback of Roe v. Wade. Ehrenfeld said that governments are becoming more involved in healthcare decisions amid attacks on science and evidence-based care. Doctors also face administrative burdens and the "financial blow" of substantial student loan debt and dwindling payer reimbursements.

Dr Jesse Ehrenfeld

"When you adjust for inflation, the payment rate to physicians who care for Medicare patients has dropped 26% since 2001. By the end of the calendar year, there'll be another 3.36% cut to Medicare payments, which will be devastating," he said.

Ehrenfeld warned that the long-feared physician shortage is already here and that it will most affect lower-income families with high needs. More than 83 million Americans do not have access to a primary care provider, 80% of US counties do not have an infectious disease specialist, and pregnant women in some states cannot find an ob/gyn to care for them, he said.

Although the challenges are complex, they're not without solutions. Ehrenfeld urged Congress and the Biden administration to take immediate action by passing multiple pending bills, many with bipartisan support, before physicians "abandon medicine altogether."

"Consider that 1 in 5 physicians surveyed during the pandemic said that they plan to leave medicine within the next 2 years, while 1 in 3 said they were going to cut back on their hours," he said. Since it can take a decade or more to educate and train a physician and almost half of the current workforce is older than 55, the shortages will likely worsen without drastic action.

Ehrenfeld suggested five steps to get the nation's healthcare system back on track; several of the points align with the AMA Recovery Plan for America's Physicians:

• Pass meaningful Medicare payment reform, such as the Strengthening Medicare for Patients and Providers Act, which was introduced in the House of Representatives earlier this year, to bolster financial support of private practice physicians.

• Reduce administrative burdens, including streamlining prior authorization processes as outlined in the Improving Seniors' Timely Access to Care Act.

• Approve legislation that creates more efficient pathways for foreign-trained physicians to practice in the US and expands residency training opportunities for primary care and other specialties facing shortages.

• Stop criminalizing physicians for providing safe, evidence-based services such as abortion and gender-affirming care.

• Ensure physicians can access mental health support without jeopardizing their licensure or career, which requires updating "outdated and stigmatizing language" often used on applications.

Steph Weber is a Midwest-based freelance journalist specializing in healthcare and law.

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Cite this: AMA Urges Legislative Action to Combat Growing Physician Shortage - Medscape - Oct 26, 2023.