Brandon M. Welch
How telehealth can help ease the physician shortage
January 02, 2024
By Brandon M. Welch
In an era when too few physicians are available to treat too many patients, telehealth is there to help bridge the gap and alleviate the doctor shortage.
But for virtual care to have the greatest possible impact, more providers need to realize just how valuable telehealth can be to the profession and to take advantage of it.
And the sooner the better because over the next decade or so, the demand for physicians is expected to continue to outstrip the supply. By 2034 there could be a shortage of between 37,800 and 124,000 physicians, according to a report by the Association of American Medical Colleges.
That’s admittedly quite a range, but regardless of where the actual number falls, it will be significant and needs to be addressed.
The physician shortage is happening for a number of reasons, one of which is the aging population that has a greater need for healthcare. By Jan. 1, 2030, every baby boomer will be 65 or older.
Physicians themselves also are aging and retiring. Some will be replaced by a new generation, but the cost of going to medical school can cause some people in that younger generation to have second thoughts about the profession.
Meanwhile, doctors don’t always live where the people do. About 20% of U.S. residents live in rural areas, but only 10% of doctors do, according to a report by the American Hospital Association.
That leaves those rural communities with limited healthcare options. They don’t have access to the specialists they need, or their local hospital might not have the in-house expertise for urgent care cases like stroke, heart attack, and trauma. Often doctors at those rural hospitals stabilize patients and then send them – sometimes unnecessarily – to a specialist at an urban hospital.
It is in these sorts of situations that telehealth shines, making up for the physician shortage in some areas and eliminating travel for patients.
There have been instances where patients traveled two to four hours from a rural community to an urban hospital, only to learn that their condition was such that a specialist at the urban medical center could have cared for them remotely. In some cases, it turned out that patients didn’t even need the specialist’s care at all. A telehealth call could have revealed that, saving everyone time and trouble.
Telehealth and physician burnout
But telehealth helps with the physician shortage in more ways than putting a doctor on a screen in front of a far-away patient.
It can improve the lives of the doctors themselves.
Many doctors are struggling these days with their own troubles, such as burnout and a lack of job satisfaction. The American Medical Association’s 2022 National Burnout Benchmarking report showed that just over half of physicians surveyed were experiencing burnout. This can cause them to say farewell to the profession earlier than they planned, leaving yet another gap in the availability of medical care.
Telehealth plays a role in reversing this trend.
How so?
When they aren’t tied to a location, doctors have more flexibility in designing their work schedules. They also can choose between more free time or seeing more patients in a shorter period of time. Those added options can help improve their satisfaction with their careers and reduce burnout.
In this way, while telehealth may not add to the number of physicians, it certainly can help reduce the number of doctors who are prematurely leaving the profession.
Provider-to-provider collaboration
Telehealth also allows medical professionals to assist each other and share knowledge, such as when a primary care physician and a specialist collaborate virtually to develop a coordinated care plan for a patient.
When it comes to how provider-to-provider telehealth assists with the physician shortage, a good example is Project ECHO, which has been around for two decades and enjoyed remarkable success.
Sadly, Project ECHO came about because of a preventable tragedy, according to the non-profit organization’s website. One day about 20 years ago a 43-year-old widow and mother of two visited Dr. Sanjeev Arora, a liver disease specialist in Albuquerque, New Mexico. The woman needed treatment for hepatitis C. What shocked Dr. Arora is that the woman had been diagnosed eight years earlier, but was only now seeking medical help for her condition. When he asked why she had delayed, she said she couldn’t afford to take off work and make the five-hour trip to Albuquerque, where the closest specialist was. She also had those two children to worry about. Finally, though, the disease forced her hand. Her abdominal pain grew so great that it was interfering with her ability to work.
By then the woman’s hepatitis C had progressed too far and she died six months later. Dr. Arora, though, made sure her death was not in vain. He realized the main problem was a lack of doctors in her community who had the necessary expertise to treat hepatitis C, and that was true of much of New Mexico, which is the nation’s fifth-large state geographically with nearly 122,000 square miles.
Dr. Arora had a brainstorm. Since he couldn’t possibly see every patient who needed his care, he created a free telehealth educational model to mentor doctors across the state on how to treat the disease. From those humble beginnings, Project ECHO has grown into a global operation covering numerous specialties and with participants in 180 countries.
Other programs are offering similar provider-to-provider assistance to overcome the barriers created by a shortage of specialists in many areas.
Making telehealth work for all physicians
Some physicians, such as Dr. Arora, have been making use of telehealth for years. In other cases, doctors turned to the technology only because of the pandemic, and in many cases they went back exclusively to office visits once COVID-19 numbers dropped.
What was it that separated those who embraced telemedicine from those who dropped it as soon as they could? We have found that the answer is as simple as this: Doctors who were successful using telemedicine continued to use it, and those who weren’t successful abandoned it.
Clearly, the goal needs to be to make telehealth work successfully for all physicians. The way health organizations can begin to do that includes integrating telehealth into the clinical workflows and providing adequate support and training.
Achieve that and we will have gone a long way toward helping to alleviate the physician shortage and the many challenges it presents.
About the author: Brandon M. Welch, Ph.D., is the founder and CEO of Doxy.me, a telemedicine software company, and co-author of “Telehealth Success: How to Thrive in the New Age of Remote Care” with Dr. Aditi U. Joshi.
In an era when too few physicians are available to treat too many patients, telehealth is there to help bridge the gap and alleviate the doctor shortage.
But for virtual care to have the greatest possible impact, more providers need to realize just how valuable telehealth can be to the profession and to take advantage of it.
And the sooner the better because over the next decade or so, the demand for physicians is expected to continue to outstrip the supply. By 2034 there could be a shortage of between 37,800 and 124,000 physicians, according to a report by the Association of American Medical Colleges.
That’s admittedly quite a range, but regardless of where the actual number falls, it will be significant and needs to be addressed.
The physician shortage is happening for a number of reasons, one of which is the aging population that has a greater need for healthcare. By Jan. 1, 2030, every baby boomer will be 65 or older.
Physicians themselves also are aging and retiring. Some will be replaced by a new generation, but the cost of going to medical school can cause some people in that younger generation to have second thoughts about the profession.
Meanwhile, doctors don’t always live where the people do. About 20% of U.S. residents live in rural areas, but only 10% of doctors do, according to a report by the American Hospital Association.
That leaves those rural communities with limited healthcare options. They don’t have access to the specialists they need, or their local hospital might not have the in-house expertise for urgent care cases like stroke, heart attack, and trauma. Often doctors at those rural hospitals stabilize patients and then send them – sometimes unnecessarily – to a specialist at an urban hospital.
It is in these sorts of situations that telehealth shines, making up for the physician shortage in some areas and eliminating travel for patients.
There have been instances where patients traveled two to four hours from a rural community to an urban hospital, only to learn that their condition was such that a specialist at the urban medical center could have cared for them remotely. In some cases, it turned out that patients didn’t even need the specialist’s care at all. A telehealth call could have revealed that, saving everyone time and trouble.
Telehealth and physician burnout
But telehealth helps with the physician shortage in more ways than putting a doctor on a screen in front of a far-away patient.
It can improve the lives of the doctors themselves.
Many doctors are struggling these days with their own troubles, such as burnout and a lack of job satisfaction. The American Medical Association’s 2022 National Burnout Benchmarking report showed that just over half of physicians surveyed were experiencing burnout. This can cause them to say farewell to the profession earlier than they planned, leaving yet another gap in the availability of medical care.
Telehealth plays a role in reversing this trend.
How so?
When they aren’t tied to a location, doctors have more flexibility in designing their work schedules. They also can choose between more free time or seeing more patients in a shorter period of time. Those added options can help improve their satisfaction with their careers and reduce burnout.
In this way, while telehealth may not add to the number of physicians, it certainly can help reduce the number of doctors who are prematurely leaving the profession.
Provider-to-provider collaboration
Telehealth also allows medical professionals to assist each other and share knowledge, such as when a primary care physician and a specialist collaborate virtually to develop a coordinated care plan for a patient.
When it comes to how provider-to-provider telehealth assists with the physician shortage, a good example is Project ECHO, which has been around for two decades and enjoyed remarkable success.
Sadly, Project ECHO came about because of a preventable tragedy, according to the non-profit organization’s website. One day about 20 years ago a 43-year-old widow and mother of two visited Dr. Sanjeev Arora, a liver disease specialist in Albuquerque, New Mexico. The woman needed treatment for hepatitis C. What shocked Dr. Arora is that the woman had been diagnosed eight years earlier, but was only now seeking medical help for her condition. When he asked why she had delayed, she said she couldn’t afford to take off work and make the five-hour trip to Albuquerque, where the closest specialist was. She also had those two children to worry about. Finally, though, the disease forced her hand. Her abdominal pain grew so great that it was interfering with her ability to work.
By then the woman’s hepatitis C had progressed too far and she died six months later. Dr. Arora, though, made sure her death was not in vain. He realized the main problem was a lack of doctors in her community who had the necessary expertise to treat hepatitis C, and that was true of much of New Mexico, which is the nation’s fifth-large state geographically with nearly 122,000 square miles.
Dr. Arora had a brainstorm. Since he couldn’t possibly see every patient who needed his care, he created a free telehealth educational model to mentor doctors across the state on how to treat the disease. From those humble beginnings, Project ECHO has grown into a global operation covering numerous specialties and with participants in 180 countries.
Other programs are offering similar provider-to-provider assistance to overcome the barriers created by a shortage of specialists in many areas.
Making telehealth work for all physicians
Some physicians, such as Dr. Arora, have been making use of telehealth for years. In other cases, doctors turned to the technology only because of the pandemic, and in many cases they went back exclusively to office visits once COVID-19 numbers dropped.
What was it that separated those who embraced telemedicine from those who dropped it as soon as they could? We have found that the answer is as simple as this: Doctors who were successful using telemedicine continued to use it, and those who weren’t successful abandoned it.
Clearly, the goal needs to be to make telehealth work successfully for all physicians. The way health organizations can begin to do that includes integrating telehealth into the clinical workflows and providing adequate support and training.
Achieve that and we will have gone a long way toward helping to alleviate the physician shortage and the many challenges it presents.
About the author: Brandon M. Welch, Ph.D., is the founder and CEO of Doxy.me, a telemedicine software company, and co-author of “Telehealth Success: How to Thrive in the New Age of Remote Care” with Dr. Aditi U. Joshi.