Where Are You Doctor? Where Are You Nurse?

September 7, 2009

When ABC and NBC Television refused to accept the League of American Voters ad critical of the Obama healthcare plan, the two broadcast giants not only provided solid proof they endorse the Administration's radical agenda, they also brought into the light a question most healthcare providers have been asking themselves. Where do we find all the doctors we will need? Taking it one step further, where do we get all the nurses we will need? These are very serious questions to ask, considering there is already both a doctor and nursing shortage in the United States.

The 33-second ad was voiced by a doctor who posed a simple question, "How can Obama's plan cover 50 million new patients without any new doctors? It can't."

Why would that claim be made? At this time the United States finds itself thirty-second in the world for doctor to patient ratios. At one doctor per every 390 people in the United States we are already behind countries such as Cuba, which has one doctor per 170 people, Russia with one doctor per 230 people and Mongolia with one doctor per 380 people.

As our population grows and doctors now in practice retire, replacements are always in demand. Currently we graduate about 25,000 doctors each year and this does not even meet our current needs. It is estimated that just to stay where we are at this time, another 4,000 to 6,000 doctors must be added to the 25,000 entering the healthcare field.

The numbers can be a bit misleading, because each doctor does not attend to 390 patients. Actually, each doctor is attending to the health needs of about 100 people during any fixed period of time. To keep the same level of care under Obama's plan to cover an additional 50 million people we need to have an additional 50,000 doctors in place…. today. From that point onward, it means we will need to increase our medical school output upward to perhaps 40,000 new doctors every year. That is a huge demand and an even greater challenge for medical educators.

It could be strongly argued that with such a large medical recruitment effort being required, the same thing would happen to the medical field that happens in the military when people are drafted into service. The quality declines markedly.

What will happen to the quality of care when we are faced with increased doctor shortages, combined with the nursing shortages that already exist all across the United States? When it comes to hospitals with low staffing levels, we already know the answer. Those hospitals report higher rates of poor patient outcomes, including shock, pneumonia, cardiac arrest, urinary tract infections, slowed recovery and mortality.

At this time under our current medical and healthcare environment, we are facing a decline in the number of nursing personnel that will continue for at least the next two decades. Healthcare providers now estimate that by the year 2020 there will be 800,000 hospital vacancies or a decline of 29% from today's nursing workforce.

There have been multiple studies done related to job satisfaction and patient workload. With an ever-increasing number of patients to serve, nursing job satisfaction plummets. A full 40% of nurses claim they are unhappy with their working conditions. Only 35% of nurses surveyed rated the quality of care they provide as excellent. Almost 45% of these nurses indicated the quality of service in their hospital had declined over the past year. An astounding 83% of nurses in the survey indicated they had their patient workload increased during the past year.

If all of these problems exist now, what will it be like a year from now if another 50 million patients are added to an already overextended nursing force?

So, again we will ask the same question the doctor in the League of American Voters ad posed, "How can Obama's plan cover 50 million new patients without any new doctors?' To that we will add, "How can Obama's plan cover 50 million new patients without any new nurses?" It can't!

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Copyright ©2009 Thomas D. Segel