Putting the Cart Before the Horse

As Congress and their sycophants bicker over their current industry-sponsored 2,700-page health care bill and promise to save costs by continually bitch-slapping their physician workforce, perhaps they should consider these data:

Our findings are consistent with the possibility that economic factors such as lower fees and increased market pressure on physicians may have contributed, at least in part, to the recent decrease in physician hours. Further reductions in fees and increased market pressure on physicians may, therefore, contribute to continued decreases in physician work hours in the future.

Whatever the underlying cause, the decrease in mean hours worked among US physicians during the last decade raises implications for physician workforce supply and overall health care policy. A 5.7% decrease in hours worked by nonresident physicians in patient care, out of a workforce of approximately 630 000 in 2007, is equivalent to a loss of approximately 36 000 physicians from the workforce, had hours worked per physician not changed. Although the number of physicians has nearly doubled during the last 30 years, many workforce analysts and professional organizations are concerned about the adequacy of the size of the future physician workforce. This trend toward lower hours, if it continues, will make expanding or maintaining current levels of physician supply more difficult, although increases in the number of practicing physicians either through increases in the size of domestic medical school classes (ed's note: expensive option) or further immigration of international medical graduates (ed's note: cheap option) would mitigate those concerns. Moreover, if this trend toward lower physician hours continues, it could frustrate stated goals of health reform, which may require an expanded physician workforce to take on new roles and enhanced functions (ed's note: as nurse managers and transcriptionists) in a reformed delivery system.

Yep, I'm seeing nothing but good things ahead if the current health bill before Congress is passed.

-Wes

Staiger DO, Auerbach DI, Buerhaus PI. "Trends in the Work Hours of Physicians in the United States" JAMA. 2010;303(8):747-753.