Internal Medicine in the state of Texas are Experiencing Hardships, Heres Why
By: Cory Ellerd
Submitted: 2010-04-28 16:00:34 | Word Count: 1155
As is the case in other places in the country, Internist Medicine in Texas is going through many of the same rough patches as other specializations. Of the nearly 63000 doctors in the state of Texas, 7713 specialize in Internal Medicine. For many of the 7713 Texas internist doctors the future is uncertain. Of those 7713 physicians, 7369 are M.D.'s and 344 are D.O.'s. While there may be some differences in training, both M.D.'s and D.O.'s are equally accredited and able to become an Internist. An Internal Medicine physician generally has at least 10-12 years of education including a B.A. (undergraduate) in a healthcare or science related area, a medical doctorate (graduate, Alleopathic or Osteopathic), and an accredited Internal Medicine residency (post-graduate).
Until the recently approved reforms to healthcare are realized, and to the current political shifts and prospective resulting consequences are also, the healthcare industry will be in limbo. The current climate in the industry is very similar to what happened when Hillary Clinton was rallying the push for healthcare reorganization in ‘93. Only when it becomes apparent what the future will be, hospitals and physicians are unable and uneasy to make plans for the trying times to come.
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The new health care reform, recently signed into law, from Obama claims to:
* makes insurance more reasonable by providing the most prominent middle class tax hack for health care in history, reducing premium
costs for many millions of families and small business owners who are priced out of coverage today. This helps over 30,000,000 Americans afford health care who do not get it today – and makes coverage more within means for many more.
* set up a new competitive health insurance market giving tens of millions of Americans the exact same insurance choices that members of Congress will have.
* bring greater responsibility to health care by laying out no nonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.
* end discrimination against Americans with pre-existing situations.
* put our budget and economy on a more sure path by reducing the deficit by $100 billion over the next ten years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.
It is also clear from their spectacle that they are getting ready for attacks based on expense to the American Taxpayer and to the idea that both Social Security and Medicare are at risk, that the change will simply rob Peter to pay Paul. These concerns are addressed upfront: "The Act will protect and preserve Medicare as a commitment to America’s seniors. It will save thousands of dollars in drug costs for Medicare beneficiaries by closing the coverage gap called the “donut hole.” Doctors, nurses and hospitals will be incentivized to improve care and reduce unnecessary errors that harm patients," and further they state: "The financial health of Medicare will improve and guaranteed benefits will be preserved by ending the 14% average overpayment to private insurance companies under the Medicare Advantage (MA) program." So not only are they protecting Medicare, but they are reducing costs, almost a hat trick.
Weak Economy
With the current economic decline and enormous job losses across the country, these have unswervingly affected the cash flow to doctors and physicians. When jobs are nowhere to be found, the deficit of healthcare benefits is guaranteed, and so access to health care is also. However, many physicians are postponing retirement since watching the stock market crush their retirement assets. This delay will result in a much smaller number of employment opportunities being offered and residents who are graduating not finding as many unfilled job opportunities as before. Residents today appear to prefer not to commit to less desirable careers, and are choosing locum tenens opportunities. They are also putting off committing to full-time employment because of the scarcity and lower remunerations. So in the predictable future, it appears there will be a lack of good careers available.
Demographics: TX and USA
In the United States, the population of 65+ is going to double by 2035 and will peak being almost one fifth of United States inhabitants. In the Alamo state alone, 62.2% of the residents are between 18 and 65. That accounts for about 15 million more people who will have passed the retirement age in 45 years. There are currently less than three, some studies show less than two, million individuals over the age of 65 currently. At the current rate of resident growth for the state, that is a very steep and sudden climb for any demographic. Even though older citizens are healthier than previous generations, the numbers of disabled and chronic condition sufferers are on the rise. So the demand for health care will rise for the next 25 years and beyond. This is the driving force behind the constant growth for demand of physicians, which may result in shortages of available medical services.
Aging is also directing the supply of physicians. Up to 1/3rd of the current 650,000 practicing physicians will be considering retiring by the year 2020. The state of Texas will be left with less than thirty thousand of todays physicians to care for over 30 million people. A shortage of primary care physicians, such as Internal Medicine physicians, is a special concern due to this, and also the selection of younger healthcare providers to choose to further specialize. The reason behind this is that further specialization beyond primary care is needed for higher salaries to pay for their pricey education. The shortage is expected to hit rural and underserved areas the hardest.
Even with the health bill finally signed into law its effect on our health care is not known. By 2014 their will be an enlargement in the enrollment into health care insurance programs. This increase when, combined with the long term aging of the population, should push demand for services and therefore cost higher. However, no one yet knows what will happen to reimbursement rates from Medicare and this new program. The question is will there be rate a cut of reimbursement rates for different specialties by Medicare and this new program that may conversely become a decreasing factor of the income of all specialties, including Internal Medicine.
Clearly the Obama administration has its hands full. We are getting older and there are fewer young people to carry this mounting financial task. The Sins of the Fathers.....
