A sobering study by the American Association of Medical Colleges (AAMC) predicts an unthinkable shortage of between 37,800 and 124,000 doctors by 2034. If underserved populations had fewer barriers to medical care, that shortfall could reach over 180,000! Successfully navigating these uncharted waters will require strategic planning and innovation.
Even the current state is so dire that the American Medical Association (AMA) developed a critical action plan: AMA’s Recovery Plan for America’s Physicians. Its focus is supporting doctors while removing obstacles and burdens that adversely impact patient care. Many inherent stressors accompany the practice of medicine and take an enormous toll, even on those whose armor once seemed impenetrable. Fortunately, the AMA’s plan acknowledges prioritizing physicians’ well-being as essential to meeting the nation’s health goals.
Without compassionate, high-functioning physicians, our country cannot realize its potential to be a consistent world leader in health care. But physicians, the admirals in our medical system, will continue to burn out in high numbers without an acceptable work-life balance and job satisfaction. Yet, with an appreciation for and anticipation of the demands and challenges future physicians will face, we can succeed in stopping the hemorrhaging of doctors from clinical practice. America needs strong leadership to prevent a revolving door into and out of the field of medicine.
But there are more warning signs. The nursing shortage is another reverberating shock to our health care system. According to the Nurses.org 2021 State of Nursing Survey, 87 percent of nurses feel burnt out. Another 83 percent feel their mental health has been compromised. Many feel underappreciated, overworked, and underpaid — frustration with patients and feeling unsafe at work within the past year tied at 58 percent. The potential for a downhill spiral is palpable. Future attrition will exacerbate the stress on those left to care for patients, resulting in even more nurses leaving the profession. As more captains of health care (nurses) leave, our foundation becomes weaker.
On September 1, 2021, the American Nurses Association (ANA) wrote a letter to the U.S. Department of Health and Human Services (HHS) imploring America to declare a national crisis due to the critical nurse staffing shortage. For our health care system to thrive, we need strong admirals (doctors) and captains (nurses), but that’s not enough. We also need health care consumers (patients) to be appropriately trained and enlisted as frontline seamen, empowered to fight for our medical system by playing an unprecedented role in their care.
In the past, America had a very paternalistic health care system. Doctors told patients what to do, and they did it (or quietly protested at home by not following their doctors’ recommendations). As a result, there is an enormous gap between how medical professionals and patients think. Americans need education on how to have highly effective conversations with those to whom they entrust their lives. But unfortunately, we have yet to thoroughly teach the basic skills they need to position themselves at the center of their health care teams. Doctors go to medical school to learn how to diagnose and treat diseases. Nurses learn invaluable skills in nursing school. But no ‘patient school’ trains patients on how to be efficient and effective patients.
For instance, most primary care doctors know eight key elements are vital when evaluating a new problem. These evaluation and management elements are directly tied to insurance reimbursements. More importantly, they help narrow down the list of potential diagnoses. A smaller list of possibilities translates into the need for fewer tests to get the correct diagnosis.
Fewer tests result in lower risk to patients and less waste. Most importantly, a speedier diagnosis at a lower cost is a much-needed win-win for patients and the U.S. health care system. These eight elements are straightforward: severity, location, duration, associated signs and symptoms, quality, modifying factors, timing, and context. But why are most patients oblivious to their existence or their significance?
A revolution in patient empowerment should be a priority on all levels: individual, institutional, and national. America is rapidly approaching a tidal wave that threatens to sink our ship. We need innovative ways for health care professionals and patients to work together like a fine-tuned vessel; our success could set the standard for patient empowerment worldwide. Multiple levels of expertise and skill sets are needed when facing any critical battle. Nothing is more critical to our health and well-being than our medical system. America needs all hands on deck to preserve it, both now and in the future.
Ann M. Hester is a board-certified internal medicine physician with over 25 years of experience and can be reached on Twitter @Patient101Book, TikTok @patientempowerment101. She is the author of Patient Empowerment 101: More than a book, it’s an adventure!