Question: Can there ever be too many physicians? Will licensing boards ever bring DCs and naturopaths into the realm of DOs and MDs? What do you think? In the WSJ I read that there are 300 physicians for every one U.S. Citizen. The article highlighted that this ratio exceeds that for every other westernized country. What do you think?


[/QUOTE]In the WSJ I read that there are 300 physicians for every one U.S. Citizen. The article highlighted that this ratio exceeds that for every other westernized country.


Just doing the quick math, but that's a LOT of damn doctors! Three hundred of us taking care of one person, what are we gonna do? rolleyes.gif

So… there are more physicians in the country then there are people in the country? That can't be right. I must be misunderstanding. Doesn't that break some laws of physical dimenstions?

Come on folks,
Naturally, I got the numbers reversed. I was probably thinking about a case while writing the e-mail.
All kidding aside-I am interested in your thoughts.

Ah, that ratio makes much more sense… so, my opinion on dilution is this: supply and demand are linked. If there suddenly become too many doctors of any sort, though I seriously doubt this will happen, potential medical students may decide to pursue different careers because medicine is not as lucrative anymore. I think it’s fairly self-regulating. As for your ND/DC question, I’m not really sure about DCs, but looking at the history of osteopaths from, say, 50 years ago, I can see a lot of similarities to where naturopathy is now, so I think that field has a great potential for growth, and honestly, I view that as a very positive thing. We need to recognize the varied needs and desires of our patients. They are not stupid and do not want to feel that they are excluded from having a voice in their own care… if a patient feels better about seeing a naturopath or any other complementary practitioner because they feel they get something out of it, then I think we have a responsibility to ensure that adequate care is available. Each person involved in health-care brings a uniqueness to the table and physicians should respect that rather than feel antagonistic toward their colleagues, whatever initials may follow their name… My own two cents. In this vein, if you are looking for some good reading material, I would recommend “The Lost Art of Healing” by Bernard Lown, MD. It’s really inspirational and he has quite a few great comments on the roles of complementary medicine in traditional practices.

I've read that figure in other sources and it is only an average across the nation. The per capita ratio of physicians varies greatly by location, being much different in urban areas with large medical centers and suburbs versus rural areas.

Just wanted to add the thought that there are still LOTS of medically underserved areas sad.gif . Until the day comes when these no longer exist, there can’t be enough doctors out there.

Not to change the subject…just wanted to send a shoutout to saralane!! How’s life at Morehouse? Hope to join you there one day tongue.gif Say hello to Karen Lewis for me!
Ok, what were we discussing? laugh.gif

Well, I didnt know the United States was the lowest in number of patients per doctor; I thought we were somewhere in the middle of the pack.
Keep in mind that there have been quite a few new osteopathic schools opened lately; their full impact on the number of docs is still ahead of us in the future.
Here are the recent new DO schools:
Touro: 1997
LECOM-Florida branch: 2003
Virginia Tech: 2002
Pikeville: 1997
AZCOM: 1995
In addition to these schools, theres talk of opening a couple of more DO schools in the near future. Each of these schools takes 60-200 people per class, so as a collective whole they will have a substantial impact.
There are 2 new MD programs that have opened recently:
FSU: 2001
Cleveland Clinic: 2002
As for naturopathic schools (ND) theres only a handful of them around the country. Right now they suffer from a lack of standardized curriculum and accreditation–each one kinda does their own thing.
That being said, in Arizona, naturopaths have full prescription rights just like MD/DOs and are recognized by law as full blown primary care physicians. They tend to use more herbs and plant medicines than mainstream meds, but the point remains that that they have the same scope of practice as a family practice doc. There’s talk of also getting them hospital privileges, in which case they would be de facto internal med docs as well. I think Arizona is the only state where NDs can basically substitute for family practice MDs, but theres a push to have the same thing happen in Hawaii and a few other states I believe.
DCs are advocating for similar practice rights–theres a group advocating for prescription rights and hospital privileges. As a group they are fairly factioned; many of them believe that conventional medicine is almost never warranted and does more harm than good.
In addition to DCs and NDs, PAs and NPs have seen their practice scope extended in a number of states. In most rural areas, they function as a full blown MD/DO with only intermittent chart review, maybe once per month. In many rural clinics, PA/NPs run the full show, and the only requirement is that a MD/DO periodically review their charts from a remote location–the MD/DO doesnt even have to be on site at the clinic.
Unless the new DO schools (which tend to emphasize more rural, primary care) vastly increase the number of rural docs, long term (15-20 years) I think the state governments are eventually going to give midlevel health care providers full medical scope equivalent to a family practice MD/DO. The cost savings are too high to ignore and there are so few rural docs that most states are desperate to do whatever it takes.
Beyond that, my crystal ball gets hazy and I cant make any clear predictions wink.gif

Let me just add that right now I dont think docs have anything to worry about. Increasing the number of docs is OK for the moment.
The problem is that once new schools are opened, it is very difficult to shut them down. We need to be very careful that we dont open too many new schools too quickly. Once new schools are opened, there is going to be stiff public pressure not to close them down, even if it is damaging to doctors currently practicing.
That being said, right now I havent heard of any docs unable to find work so the demand-supply pool still favors us. If and when we start hearing anecdotes about unemployed docs, or if salaries fall drastically (maybe to 90k average or so, right now the average is about 165k) then I would be worried.

Thanks for the shout out! Actually classes don't start until next week-July 10th. MSM must be the ONLY school that starts that early. I enjoyed your little biographical info - I also have been a student at GSU, GPC and UGA (UGA graduate 2003, BS psychology). Go Panthers, go dawgs and - what the heck is GPC's mascot? Maybe a ferret?

Don't forget that there are also tons of IMG/FMG's.

According to the BLS, most specialties will be growing much faster than average. Our population is aging so…
Also, the 600:1 raw number doesn't really mean much. For instance, one person may require the services of several specialists.