US national policy issues looming after healthcare?

On the supply side, are there too few physicians? A simple calculation estimating the number of physicians needed to care for all US residents suggests no physician shortage.

The United States currently has more than 900 000 active physicians. Of these, 441 735 are primary care physicians and 484 384 are specialists. Approximately 12% of primary care physicians work part time, leaving slightly more than 388 000 full-time primary care physicians. Of these, nearly 80 000 are pediatricians.

According to recommendations from the Agency for Healthcare Research and Quality, the average physician panel size—the number of unique patients under the care of an individual physician—should be between 1500 and 2000. A recent Medical Group Management Association survey of primary care physicians found that the median panel size was 1906 and the average was 2184.

Conservatively, if each of the 388 000 full-time primary care physicians cares for an average of 1500 patients, they could care for an estimated 583 million people. Today, there are 240 million adults in the United States.

Even at the low panel size of 1500 patients, all adults could be cared for by 160 000 primary care physicians; at a panel size of 2000 patients, the United States would require an estimated 120 000 full-time primary care physicians.

Similarly, the 73 million US children younger than 18 years could be cared for by an estimated 49 000 pediatricians, assuming that each provides care for 1500 patients, or by an estimated 36 500 pediatricians with panel sizes of 2000 patients. Add to these conservative calculations the care provided by the more than 50 000 part-time primary care physicians and there seems a significant surplus, rather than a shortage, of full-time primary care physicians.

Can Physicians Care for All Patients in the United States?

Another way of determining if there are enough physicians is to approach the issue from the demand side. Each year, there are 930 million US physician visits, 54.6% (507 million) of them to primary care physicians. If each primary care physician sees patients in 30-minute appointments for 6 hours a day (12 appointments per day) to ensure patients are thoroughly examined and visits are not rushed, then 43 million primary care physician workdays per year are needed (507 million visits divided by 12 visits per day). If physicians work an average of 200 days per year, then an estimated 215 000 active, full-time primary care physicians would be needed for all the primary care office visits in the United States. That number is nearly identical to the estimated 209 000 internists, family physicians, and pediatricians (160 000 + 49 000) needed based on the conservative panel size calculations.

From either a supply or a demand perspective, enough physicians are available for all US patients. Given this balance, and assuming these estimates are accurate, there is no obvious physician shortage.

here is no obvious physician shortage.

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4. Idaho
> Doctors per 100,000 people: 172.5
> Medical students per 100,000 people: N/A
> Pct. without health insurance: 17.7% (11th highest)
> Life expectancy: 79.2 years (20th highest)

Although Idaho's doctor shortage is among the worst in the nation, the state's lack of medical residents is potentially just as problematic. There are just 3.9 medical residents per 100,000 people in Idaho — the second-worst figure in the U.S. and well below the national figure of 35.8 per 100,000. The Pending retirement of doctors in the state is also an issue. In a report on Idaho's doctor shortage, NPR noted that 41.5% of physicians in the state are 55 and older. Idaho is one of just a few states that has no accredited medical school.

“Before he makes any decision, he posts on Twitter.
He tweets and then checks the responses in order to make his decision."

And rural schisthole states like Idaho don't attract as many doctors, per this U.S.A Today ranking that has Idaho as the 4th worst state for doctors per 100,000 population. Mississippi of course is the worst & the best ratio state, Massachusetts, has nearly twice as many doctors per 100,000 as Idaho does.