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Increase in Patients Creates Large Demand for New Clinicians

Despite a difficult economy, medical schools are undergoing rapid expansion, scrambling to meet an increasing demand for new clinicians.

Medical campuses across the U.S. are expanding and creating new branch campuses, said Alex Stagnaro-Green, senior associate dean for education at the George Washington University School of Medicine. Ten new medical schools have recently been established or are in the process of being created, he said.

Nationally, “there is a growth of student numbers we haven’t seen since the 1960s or 1970s,” Stagnaro-Green said.

Even before healthcare reform added an estimated 32 million previously uninsured Americans to the coming decade’s patient pool, aging baby boomers were creating a predictable increase in demand for primary care physicians and specialists. The elderly face markedly higher cancer rates than younger populations do, so as America’s elderly population grows, more surgeons and oncologists will be needed. Due to increasing rates of chronic diseases associated with obesity, such as 2 diabetes, younger adults coming into the ranks of the insured will create new demand for endocrinologists and other specialists.

Shortages in physicians are already evident in some, mainly rural and inner-city, areas of the country. By 2020, doctor shortages will become acute, with approximately 91,000 too few physicians in the workforce, according to Association of American Medical Colleges chief advocacy officer Atul Grover.

Closing the gap will require teaching hospitals nationwide to prepare an additional 4,000 physicians-in-training each year, but current federal primary-care workforce grants and health service funding will add only 500 to 600 a year, Grover said. Medicare’s funding for resident positions has been static since 1999, and expanding that program to train the needed numbers of new physicians could cost $1 billion a year, he said.

“The fiscal environment is a real challenge right now,” Grover said. “But you can’t just take freeze-dried doctors off the shelf when you need them.”

Anticipating more demand for non-physician clinicians like advanced practice nurse practitioners and physician assistants, nursing programs are expanding

as well. Health reform’s emphasis on an “accountable care” model that coordinates patient care across clinical disciplines will also increase demand for non-physician

clinicians--and cooperation among physicians and other clinicians.

“A big part of the challenge now is how to train folks less as autonomous individual health care providers and more as teams,” Grover said.

Nursing programs are expanding curricula to include more interdisciplinary team training, care for the frail elderly, as well as areas prioritized in the health reform law, such as health information technology, said George Washington University School of Nursing founding dean Jean Johnson.

Health reform’s emphasis on disease prevention as a cost control mechanism has also prompted nursing programs to increase their emphasis on public health and patient education.

“There are already some duel-degree nurse practitioner (and public health) programs,” Johnson said. “We’re in a conversation with our School of Public Health right now.”

As the number of medical schools and programs expands, so will the need for new instructors. A “severe shortage” of nursing instructors prompted George Washington University’s creation of a Doctor of Nursing degree program, Johnson said.

“We’re adding teaching assistantship opportunities as well,” she said.

This special advertising section was written by Bryant Furlow, a freelance writer, in conjunction with The Washington Post Custom Content department. The production of this supplement did not involve The Washington Post news or editorial staff.