Is there a shortage of CNA Nurses? If so CNA nursing may be the ideal job career to enter. In this post entitled CNA Shortage Nurse, we look at this issue and why you should take up CNA classes now.Listen as Tom Gjelten explains:
CNA Shortage Nurses
This is TALK OF THE NATION. I’m Tom Gjelten, in Washington, sitting in for Neal Conan. It’s bad enough that a visit to the doctor’s office can be expensive. Maybe you worry about the quality of care you’ll receive. But that’s not all. A common complaint these days is the length of time we have to wait before we see someone who can help us.
There’s a doctor shortage in this country, and it’s bound to get worse. The new health care law expands coverage. There’ll be more patients waiting to see fewer and fewer doctors. The Association of American Medical Collages projects that by 2015, in just three years, we’ll be 63,000 doctors short of the number we need. And that number could double by 2025.
We want to hear from primary care providers, doctors, nurses, nurse practitioners, physician assistants. What do you think is behind this shortage? Our number is 800-989-8255. Our email address is email@example.com. And you can join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.
Later in the program, Max Fisher of The Atlantic shares his survey on travel guides for foreigners in America. But first NPR health policy correspondent Julie Rovner joins us in Studio 3A. Hi, Julie.
JULIE ROVNER, BYLINE: Hi.
GJELTEN: So how serious is this primary care situation in the country right now?
ROVNER: It’s pretty serious, and it’s not a surprise. It’s been serious since before the health law was passed. It’s mainly serious because of the demographic shift. You’ve got the baby boom generation rapidly aging, rapidly aging into Medicare eligibility.
GJELTEN: And needing more health care.
ROVNER: Exactly, as you age, you need more health care. Obviously, you need more frequent health care and more intensive health care. So we knew that we were going to be looking at a health care shortage. The other problem with that is that the health care workforce itself is aging.
Remember a lot of them are also baby boomers. So at the same time, you have a generation that’s going to need more health care, you have more health care professionals who are going to be retiring. So you have sort of a dangerous combination there. You’re going to have a smaller generation behind this generation to take care of this baby boom generation, and you’re going to have this baby boom generation needing more care.
Then you layer on top of that the Affordable Care Act, the 2010 health law, that’s going to cover an additional now they’re saying 30 million people, and you’ve got a big mess. On the other hand, the Affordable Care Act knew about this. I mean, the people who put that together saw there would be a problem.
There’s an entire – one of the titles of that act is – talks about expanding the primary care workforce.
GJELTEN: Well, let’s take these things one piece at a time, Julie, OK, so as not to get overwhelmed. First of all, why are not more people going to medical school? Why aren’t we graduating more doctors? If there’s such a demand, you know, you would think this would be an attractive profession to go into, why are we not seeing more doctors becoming – graduating from medical school?
ROVNER: Well, we are. There are actually several new medical schools. That’s not the bottleneck. We are indeed graduating more doctors from medical school. What there is a shortage of are residency positions. So the bottleneck is in the residencies. In 1997, Congress capped the number of residencies that could be funded by Medicare as a cost-cutting provision.
The problem is there are too many of these graduating MDs who are going into specialty care and not primary care.
GJELTEN: They all want to be dermatologists.
ROVNER: They all – that’s exactly correct. They all want to be dermatologists. The ones who don’t want to be dermatologists want to be radiologists. The ones who don’t want to be radiologists want to be emergency room doctors because they can set their own hours.
People don’t want to go into primary care. It doesn’t pay as well, it’s much more stressful, and it’s – the lifestyle is really not that conducive to, you know, having a family, trying to live a, you know, a structured life, and that’s not what today’s medical student wants to do. Plus you graduate with hundreds of thousands of dollars in student loans. It’s difficult to pay those back.
All the incentives point these graduating medical students away from going into primary care.
GJELTEN: And where is the situation the worst?
ROVNER: This situation is the worst in the places that people would least like to live, in rural areas in particular, in the inner cities, in places that the government has designated these health care professional shortage areas. So, you know, if you think about where there are not a lot of people and where it’s maybe, you know, not that pleasant, where it’s really cold in the winter or really hot in the summer, or there really aren’t a lot of big cities. That’s where it’s hardest to recruit doctors.
GJELTEN: So what is happening? Is there any way to provide incentives for doctors to choose primary care or family medicine as their specialty, as their practice?
ROVNER: Yes, there is. And that’s what was in – that’s exactly what the law tried to do. One of the things is you can give graduating students or residents loan forgiveness. You can say hey, you’ve got these hundreds of thousands of dollars in medical school loans, we will help you pay off your loans if you agree to come serve in these under-served areas. If you agree to stay in these under-served areas, we’ll pay off even more of your loans. That’s one of the ways.
They can give special dispensations going in for people who will – who agree to become primary care practitioners. A lot of the money in the Affordable Care Act went to beef up programs that train primary care providers, not just doctors but nurse practitioners, physician assistants, what we call mid-level providers because remember primary care doesn’t necessarily have to be provided by someone with an MD after their name. And that’s going to be one of the ways that people who study in health policy think that this shortage will be alleviated, not just by having more doctors but by having doctors work in teams with other less highly trained specialists who can deliver good primary care. There’s lots of studies that say good primary care can be delivered by people like nurse practitioners, by physician assistants, by nurses.
GJELTEN: And we’re also seeing more doctors coming from other countries, who have even, in some cases, I imagine, been trained in foreign medical schools.
ROVNER: Well, that’s always been the case. And again, you know, that does – you get two things. You get doctors coming from other countries who are already trained, are already MDs, and you get doctors coming from other – from foreign medical schools, these foreign medical graduates, who are coming and taking U.S. residencies. And in fact many of them are filling these primary care residencies that the U.S. medical school graduates don’t want because they’re all taking the specialty residencies.
GJELTEN: You know, Julie, I was talking to a doctor friend the other day who had actually – was getting out of medicine. And she was getting out of medicine because she said it was too stressful. She said that in her practice, she needed to see something like 40 patients a day in order to cover overhead and everything else. How serious are some of these quality-of-life issues for doctors, and are doctors who have been trained, are they actually leaving the profession now because they find it too stressful or too difficult or not sufficiently remunerative?
ROVNER: It’s a really tough time to be a doctor. You know, people don’t have a lot of sympathy for doctors, many of whom make, you know, obviously – almost all of whom make six-figure salaries, many of whom make upper six- and seven-figure salaries. But it really is – it is definitely a time of transition.
Insurance companies put a lot of pressure on doctors. There’s a lot of change in how the practice of medicine is working. There’s a lot to keep up with, and a lot of doctors are actually selling out their practices to hospitals so they can have a little bit more, you know, financial security, if you will, trying to figure out what it is that they’re going to do.
But, you know, for doctors just starting out, it is really difficult to know, you know, just how you can do this financially, you know, have some financial viability. As I said, if you’re paying off enormous student loans, trying to make a go of it, trying to do your patients well. I hear a lot of doctors worried about whether they can give patients enough time to really legitimately take care of them.
GJELTEN: Well, let’s hear from some providers. Steve is on the phone right now from Idaho Falls, Idaho. Good afternoon, Steve, thanks for calling us.
STEVE: Hi, thanks for talking with me. I’m a big fan.
GJELTEN: Good. All right.
STEVE: So, you know, I’m – neurology is sort of close to primary care. We don’t have…
GJELTEN: Neurology, you’re a neurologist.
So you see why becoming a CNA Nures assistant look so promising. Where there is a demand there is guaranteed work as long as you qualify. So do take a look at a Nursing career as its rewarding and also there is a need. if you liked this post entitled CNA Shortage Nurses then please click the like button below.