The shortage of physicians can be deadly for patients
As an emergency room physician, I am deeply saddened by the recent death of Tashonna Ward, who died while waiting for a doctor to see her in Milwaukee last month. Generally, emergency department teams try to identify sick individuals and give them timely attention.
However, this case shows the potential outcomes for a health care system that is stretched too far, and medical professionals who are stretched too thin. And here’s the awful news: Things are only getting worse.
After Ward’s death, about five hours after she went to the emergency room for shortness of breath and chest pain, the Milwaukee Journal Sentinel reported that many people posted stories on Facebook of their long waits in emergency rooms. In the same article, ProPublica corroborated that average wait times in the particular emergency department Ward went well over four hours. I can’t imagine the wait times at many emergency departments in the Chicago area are any better.
While I hate to say this, these sorts of wait times are becoming more common as a result of Emergency Department volumes today. According to the Centers for Disease Control (CDC), in 2017, there were over 140 million Emergency Department visits in the United States.
Considering in the same year, our overall population for the entire country was 325 million, that number is staggering. Furthermore, the estimate from their data is that Emergency Department volumes have increased by almost 25 percent in the past 10 years and approximately 60 percent in the past 20 years.
Let me assure you, emergency room physicians know how long patients are waiting to see us, and we always worry about who is sitting out in our waiting rooms. After all, we go into the profession because we want to care for people and, if we can, heal them. But the current climate of healthcare may be taking all of us away from that goal.
Our primary care physician colleagues have schedules that are jam-packed and inboxes that are overflowing with patient messages and requests. Some specialists are so backed-up with the patients they currently care for that trying to fit in a new patient can take weeks to months. As a result, many people feel they have nowhere else to turn except the safety net: the emergency department.
Theoretically, the unmet demand for doctors means we need more physicians to do the work. However, the industry is instead losing physicians who choose to leave medicine due to this overburdened system. Physicians are burning out of practice in huge numbers, which can only result in worsening outcomes for our patients.
The real cost of physician burnout is also high: organization costs are up to $10,200 per physician, which nationally amounts to about $4.6 billion in decreased clinical hours and physician turnover as doctors seek a side gig or a “way out.” That’s money that could have been spent on patients’ healthcare. If we continue at this rate, we’ll see a shortage of over 120,000 physicians by 2032.
Despite this turmoil, our primary care physicians and medical schools are increasingly trying to focus on preventative medicine and identifying at-risk patient populations before they slip through the cracks.
Looking at the social determinants of health is a welcome direction, taking us back to the roots of medicine. But it requires team-based care with our advanced practice colleagues, nurses, social workers, pharmacists, and more. It may be the path to decreasing our population’s need to rely on emergency departments, but having fewer physicians overall means we will not be able to close the health gap in a timely fashion — if ever.
This is the truth behind the curtain — there is no Dr. Oz who will save us all. What can help the situation are patients. If you are rightly outraged about Ward’s death and scared for yourself and your loved ones, please raise your voices and demand better from the system: tweet @CMS.gov to send a message to Centers for Medicare and Medicaid Services; talk to the administrators at your health care institutions; write or visit with your government representatives and tell them more resources are needed to follow through with the good care healthcare providers want to give.
Our hearts ache for Tashonna Ward and those who love her, as well as for every individual whose life or health is threatened due to delays in treatment.
Meeta Shah, M.D., is an assistant professor in the Department of Emergency Medicine at Rush University Medical Center. She is also a Public Voices Fellow with The OpEd Project.
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