Jesse Ehrenfeld, MD, American Medical Association president, outlined a potential five-step solution to the physician shortage crisis in a speech to the National Press Club on Oct. 25.
First, give physicians the financial support they need. "This is critical for our colleagues in private practice that are the backbone of our nation's healthcare system," Dr. Ehrenfeld said.
He called on Congress to pass the Strengthening Medicare or Patients and Providers Act, which would provide physicians with annual payment updates to account for practice cost inflation.
Second, reduce administrative burdens such as "the overused, inefficient prior authorization process." Physicians spend an average of two business days a week completing prior authorization paperwork. An AMA survey found about 80% of physicians said they had patients abandon treatment due to prior authorization struggles, and two-thirds said the authorization delays led to additional office visits.
Dr. Ehrenfeld called on Congress to approve the Improving Seniors' Timely Access to Care Act, which would expand prior authorization reforms finalized by CMS.
Third, expand residency training options, provide greater student loan support and smooth pathways for foreign-trained physicians. Dr. Ehrenfeld pointed to three bills — the Conrad 30, the Physician Access Reauthorization Act and the Healthcare Workforce Resilience Act — as avenues to achieve this step.
Fourth, stop criminalizing healthcare that is widely recognized as safe and backed with evidence, namely the bans on abortion and restrictions or bans of gender-affirming care.
"Let me be clear: These efforts — fueled by misinformation and a heated attack on science and evidence-based care — have forced government into the most intimate and difficult decisions a person can make," Dr. Ehrenfeld said. "They have sown confusion for physicians and patients and opened deep political rifts between neighboring states. They have made physicians — and other healthcare workers — the target of attacks and intimidation."
Fifth, ensure physicians are not punished for taking care of their mental needs. Physician death by suicide is twice the rate of the general population, Dr. Ehrenfeld said. About 2 in 3 physicians admitted to experiencing burnout during the pandemic, according to a survey from the AMA, Rochester, Minn.-based Mayo Clinic and Palo Alto, Calif.-based Stanford Medicine, and 1 in 5 said they planned to leave medicine in the next two years.
Physicians are often reluctant to seek treatment for mental health for fear of losing their license due to stigmatized language on medical boards and health system applications, Dr. Ehrenfeld said. He called on states and employers to audit their licensing and credentials applications and remove questions about past diagnosis of mental illness or substance use disorder. Instead, he said they should ask whether a current mental health condition, if left untreated, would adversely affect patient safety.
"Our nation's physician shortage is not a problem to set aside and deal with tomorrow. It is an urgent problem we need to address today," he said. "We must take action to create a stronger and more resilient physician workforce to care for an ever-changing nation."