Researchers from the John Chambers College of Business and Economics in West Virginia University examined the primary care shortage stemming from the pandemic and offered six possible solutions.
1) Changing medical training
2) Increase the independence of physician assistants and nurse practitioners
3) Federal regulation of telemedicine
4) Expand the Interstate Medical Licensing Pact
5) Special telemedicine license
6) National license.
“COVID-19 has been very costly, but if there is a silver lining it has prompted rethinking of many healthcare regulations,” said Ed Timmons, an economist and one of the study’s authors, in a statement. “If it made sense to eliminate regulation during the pandemic, it’s worth asking whether regulation will be necessary in the future.”
Timmons and his co-author, Conor Norris, argue that professional licensing reduces the supply of professionals in a regulated field and limits geographic mobility, factors leading to healthcare shortages.
“Professional licensing laws make it a crime to work in a profession without achieving minimum levels of education and training, paying state fees and passing exams,” Timmons said. “Although they set minimum levels of entry, they also discourage entry and have a disproportionate impact on the disadvantaged. Research documents that professional licensing raises prices and increases unemployment.
When it comes to changing medical education, the authors claim that the path to a medical degree in the United States takes longer and is more expensive than in other countries. To become a doctor in the United States, you need a bachelor’s degree before completing four years of medical school, in addition to a year of residency. Medical students from countries such as Australia, Ireland, and South Korea have the option of earning a six-year consolidated medical degree.
“It would be great if interested students could complete a three-year degree for medical school,” Timmons said. “Of course, this would all depend on changing medical school admissions criteria and accepting the new three-year degree. Medical schools, however, must adhere to accreditation standards.
Timmons noted that the typical medical school graduate in the United States can rack up more than $200,000 in debt, which discourages doctors from becoming general practitioners.
The researchers also advocate that physician assistants and nurse practitioners be able to practice independently of physician supervision. Regulatory requirements in about half of the states prevent them from practicing their full training and abilities.
Access to primary care in rural and underserved areas would improve with greater independence of practice, Timmons said.
“Redesigning medical training and allowing PAs and NPs to practice independently in accordance with their training will reduce their shortage,” Timmons and Norris concluded. “Other reforms that encourage telemedicine or facilitate interstate migration will help underserved populations receive care.”