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Glenn McDermott, M.D. is an assistant professor of Clinical Internal Medicine at Eastern Virginia Medical School and medical director at Minor Emergency and Family Care Center in Virginia Beach.

In the April issue of Internal Medicine News, it was stated that primary care in the United States is a dismal mess. In reality, our health care system is a dismal mess.

Primary care is inundated with cases that are clearly meant for specialists. Not only is it difficult to schedule with a primary care doctor in a reasonable time, but in addition there are no specialists readily available even in an urgent situation.

Pick up your phone this week and call a specialist for an appointment. When will you get an appointment? One month? Two? If your case requires a certain subspecialty, it could take six months or more. This is American health care today.

Many patients have good insurance, yet they still have no access to expedient care. We have all the wealth and economics, but we still get substandard care. Medical care delayed is medical care denied, and it can be deadly.

The emergency rooms are now overloaded and take the brunt of this problem because patients can’t secure expedient care elsewhere. Even worse, the emergency room tells a patient to follow up with their primary care physician, who may be ill equipped to handle the case when it requires a specialist. We have a critical shortage of doctors and a very critical shortage of specialists. We have great medical care … if you can gain access to it in time.

It was well known for years that there would be a shortage of doctors. The powers-that-be answered it by opening more medical schools. The problem is that they did not expand residency programs simultaneously with medical schools.

Years ago, it was mandated that doctors were required to enter residency. I received my license soon after graduation and passing my boards. Many other specialists such as dentists, lawyers, certified public accountants, nurse practitioners and physician assistants can practice after getting their degrees and passing their boards, but not medical doctors.




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The New York Times published “‘I am worth it’: Why thousands of doctors in America can’t get a job” in February 2021. The article estimates that there are 10,000 fully qualified doctors who have passed their initial boards but can’t get into a residency because there aren’t enough available. Since a doctor cannot be licensed without residency experience, these doctors cannot practice at all.

It is estimated that 10,000 degreed doctors who passed their boards still could not practice medicine during a pandemic. If you think that statement is ridiculous then you are getting my message. Unfortunately, it is true. Could these doctors have saved some lives if they were practicing? I think you know that answer.

The article “Why America has so few doctors” by Derek Thompson published in February by The Atlantic supports the New York Times article. The federal government must immediately expand funds to open new residencies. Wasting 10,000 doctors’ careers during a pandemic is unforgivable, unimaginable and insanity.

State boards can also help by giving doctors some type of license while they’re waiting to get into a residency. I applaud the state of Missouri by doing that already. A bill is expected to come before the Virginia General Assembly in January to do the same.

The problem is that even if I was given all the funds and power to correct this dangerous situation, it would take at least four years to improve. This is a minimum required to train a specialist.

Call your senators and representatives and tell them this is an emergency. The federal government supports residencies and should open more residencies. The life you save may be your own.

Glenn McDermott, M.D. is an assistant professor of clinical internal medicine at Eastern Virginia Medical School and medical director at Minor Emergency and Family Care Center in Virginia Beach. He started one of the first urgent care centers more than 40 years ago.