By Jacob Madden
Want to help make a big change for our nation’s overworked doctors? Call your senator and tell them to hire more.
In March of this year, Senators Robert Menendez (D-N.J.), John Boozman (R-Ark.), and Chuck Schumer (D-N.Y.) introduced S.834, the Resident Physician Shortage Reduction Act to confront the country’s growing shortage of doctors.
The proposed legislation will increase the number of resident physician positions supported by Medicare by 2,000 each year from 2023 to 2029, for a total of 14,000 newly supported positions.
This legislation could make a small but significant dent in the nation’s physician shortage. By 2034, the Association of American Medical Colleges expects a shortage ranging from 17,800 to 48,000 primary care physicians, and 21,000 to 77,100 non-primary care physicians. Take both worst-case scenarios, and we are short 125,100 doctors.
There are two leading reasons for this shortage: population growth and aging (of both the general population and practicing physicians). Within the next decade, two out of five physicians are going to be retirement age. While many doctors continue to work long past sixty-five and are capable of doing so, do we want to push doctors to keep working when they may otherwise hope to retire?
S.834 presents a fix: it enables more Medicare-supported resident physician positions by removing a 1997 cap on Medicare payments made for graduate medical education expenses. This cap essentially has prevented the creation of new resident physician positions, despite the thousands of qualified medical students who seek such positions every year and are then turned down. Some progress has been made, with Congress approving 1,000 more Medicare-supported positions at the end of 2020. But other than that, not much has been done since 1997.
Hospitals will apply for these positions on an annual basis and will be notified by the Secretary of Health and Human Services how many positions they have been distributed. Certain categories of hospitals will each receive at least ten percent of the positions. These include hospitals located in rural areas, hospitals in states with new medical schools satisfying certain accreditation criteria, hospitals that serve areas deemed health professional shortage areas, and a number of others.
There is no doubt that this bill is a big deal. That’s why it has the support of the American Medical Association, American Hospital Association, Association of American Medical Colleges, and all kinds of other major medical organizations.
The bill, currently sitting with the Senate Committee on Finance, was introduced on a bipartisan basis. But with current political dynamics, its passage is anything but guaranteed. For one, the bill was already put forward in somewhat different forms in 2013, 2015, 2017, and again in 2019. You may think that with the pandemic, the bill would be sure to pass this time around. But just last month, a resolution brought forward in Senator Boozman’s home state of Arkansas to encourage Congress to pass the bill died in committee. So there are no guarantees.
Sure, the bill is not going to singlehandedly solve our physician shortage, but that does not mean it is just a drop in the bucket. In fact, it is a big deal. If you want to help our nation’s doctors, call your senator. Tell them to support the Resident Physician Shortage Reduction Act of 2021 and help give our doctors a well-deserved break.
Jacob Madden is a third-year student at Yale Law School.