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Our hosts for this episode are Dr. Sahil Mehta and Dr. Renee Marinelli. They are joined by Dr. Kunal Sindhu, a radiation oncologist in New York City, who is here to talk about an article he recently wrote about the looming doctor shortage.

[0:58] The impetus for writing this article.

While completing an internship in 2017, Dr. Sindhu kept hearing about how the medical field keeps getting busier and has never been like this. That spurred his interest in the topic.

[2:57] What Dr. Sindhu found was happening in the 1990s.

When Bill Clinton ran for president again in 1996, he pushed for deficit reduction. The Children’s Health Insurance Program (CHIP) came out of this, and there were other Medicare reforms part of the deficit reduction act. One of them was to cap the number of medical residents. A lot of medical groups supported this, which Dr. Sindhu finds mind boggling.

[6:26] Why the American Medical Association and other societies thought there was an excess of doctors.

Baby boomers were younger then, so there wasn’t as much of a demand for services. There were also less medical school applications. Now, it’s not as easy as just adding more seats to rectify the shortage because standards need to be kept very high.

[9:08] Increases in residencies that Dr. Sindhu has seen.

When hospitals are forced to take residents, they will add specialties that have higher reimbursement rates. Hospitals have been adding more residents in fields like EMT and neurosurgery, and tend to neglect fields like family medicine and pediatrics.

[12:17] Having more trainees but making sure they all get enough experience.

Dr. Sindhu says that there is no easy way to balance these two. The trainees in fields that hospitals will take more of due to the reimbursement amount will get less experience.

[15:42] Dr. Marinelli’s decision to not continue with family medicine.

After residency, she was expected to return to work twelve-hour workdays six days a week. It was unacceptable to her and she decided that she couldn’t do it. She believes that physicians should get assistance in finding a balance.

[18:43] Two bills that were introduced.

Both bills involve creating three thousand more residency spots. Similar bills have been introduced over the years, but they never seem to gain traction. Dr. Sindhu says this would be wonderful, but believes the country needs more.

[19:56] Getting asked about the doctor shortage in an interview.

Two points to talk about are the absolute number of physicians in the pipeline and specialty distribution. A third consideration is geographic distribution. It’s about more than just increasing the number of physicians.

[22:23] How Dr. Sindhu balances being a resident and writing articles.

Things that he sees on a day-to-day basis interest him, so he makes a note on his phone when he gets a writing idea. When he has a bit of time, he’ll write about what he noted.

Dr. Sindhu on Twitter: https://twitter.com/sindhu_kunal