Doctor and nurse shortages are unlikely

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Among the dire assumptions about the future of health care in the United States, one of the more persistent has been that the numbers of doctors and nurses are dwindling rapidly.

But several new reports released this fall suggest the shortfalls among key health workers may not be so great as once feared, at least on a national scale.

Think no one wants to work hard enough to be a doctor anymore?

At the nation's 135 accredited medical schools, the number of first-time applicants increased to an all-time high this year, with nearly 33,000 students and just under 44,000 applicants. Actual enrollment was up 3 percent, to 19,230, according to the Association of American Medical Colleges surveys released in October and December.

At the other end of the physician work span, the percentage of physicians who are 60 and older remained at about 25 percent in 2010. Although most doctors in recent decades have retired in their 60s and few are active into their 70s, several recent studies suggest that trend is slowing, helping to stave off doctor shortages.

According to the AAMC, in 2010 there were 244 active physicians and 215 physicians active in patient care for each 100,000 people in the U.S., up by about 5 percent and 2 percent, respectively, since 2008.

Even with continued growth in the number and class sizes of medical schools, the association and other groups still fear the nation could face a shortage of some 90,000 physicians by mid-century.

In early December, researchers reported in the journal Health Affairs a more dramatic trend gleaned from census surveys: the number of 23- to 26-year-olds who became registered nurses increased by 62 percent between 2002 to 2009, a rate not seen since the 1970s.

The new corps of nurses in that age group reached 165,000 in 2009, closing on a 1979 peak of 190,000. Researchers at the RAND Corp, Vanderbilt University and Dartmouth College say that if the trend continues, there should be enough nurses to meet the country's projected needs rather than face a shortage of up to 400,000 RNs by 2020.

"These findings were a real surprise and are a very positive development for the future health care workforce in the U.S.," said David Auerbach, the study's lead author and an economist at RAND. "Compared to where nursing supply was just a few years ago, the change is just incredible."

The researchers said initiatives to encourage nursing careers, coupled with new and expanded training programs, have helped fuel the increase in young nurses. A bad economy with fewer opportunities for jobs in manufacturing has also played a role.

However, a second study in the same journal showed that the new crop of nurses may not be as evenly distributed as might be desirable, particularly for patients in rural areas.

A survey by researchers at New York University's College of Nursing found that more than half of newly licensed RNs were working within 40 miles of where they attended high school. Most also attend nursing school close to home.

Among nurses with associate degrees, more than 78 percent were working in the same state where they attended high school; and 76 percent of those with bachelor's degrees practiced in their home state.

The researchers said the results suggest training programs need to be focused in areas with nursing shortages and give new incentives to students who will stay in underserved areas after their graduate.

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