Are You Ready for Doctor Shortages?

Posted on by Jesse Santiano, M.D.

A report from the AAMC (Association of American Medical Colleges) predicts a shortage of 122,000 physicians by 2032. This shortage will be across the board and affect Primary Care Physicians and ALL specialties.

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But 2032 is 13 years from now. Why should I care?

Diabetes complications and coronary artery disease do not pop out of the blue. Chronic diseases like diabetes take years to develop and affect the whole body. When a diabetic complication becomes more involved, specialists are needed. The following list will be the different specialists that a diabetic patient will see in their lifetime.

  1. Endocrinologists (Hormone specialists) – primary care physicians do an excellent job of managing diabetes. However, diabetes patients may also have other endocrine problems from the thyroid and adrenals.
  2. General cardiologist – coronary artery disease, heart failure, and heart rhythm problems (arrythmias) are widespread in diabetics.
  3. An electrophysiologist is a cardiologist specializing in the electrical conduction of the heart.  After a heart attack, patients may develop malignant arrythmias that need a pacemaker. Atrial fibrillation is also common in T2D.
  4. The interventional cardiologists do specialized x-ray imaging of the heart, including the coronary arteries and the chambers. They are the ones who will do an emergency angiogram of the heart and put a cardiac stent in coronary arteries if needed.
  5. Neurologists take care of acute brain strokes that may or may not need a clot buster.
  6. The interventional neurologist can open up a diseased artery supplying the brain.
  7. Nephrologist – the kidney specialist will take care of the kidneys as the kidneys deteriorate and will decide if a T2D will need dialysis.
  8. Cardiothoracic surgeons do the heart bypass.
  9. Vascular surgeons will implant a dialysis shunt several months before the projected dialysis. They will also take care of peripheral artery disease (PAD) complications. T2D involves all the arteries of the body. The diseased arteries in the legs may need to be opened up or have a stent put in, or else non-healing wounds can happen. The worst outcome is if the foot or leg becomes gangrenous. In that case, you will need…
  10. An orthopedic surgeon or a general surgeon to do the amputation.
  11. Surgeons are consulted in acute cholecystitis because people with diabetes are more at risk for complications.
  12. Oncologists are cancer specialists. T2D patients are also prone to cancer. High blood sugar provides enough food for the cancer cells to multiply.
  13. The ophthalmologist or eye specialist has to be seen regularly. Cataracts and complications of the eye’s blood vessels called diabetic retinopathy can lead to loss of sight if not managed appropriately.
  14. Emergency room physicians take care of sudden changes that can be life-threatening or hospitalization. Examples will be acute worsening of heart failure, arrythmias, chest pains, leg problems, and infections, to mention a few.
  15. Pulmonologists for smokers or non-smokers who will develop chronic lung diseases and pneumonia.
  16. Infectious disease specialist. Diabetics have a weak immune system making them prone to infections that a non-diabetic person can comfortably handle.
  17. The Primary Care Physician may be an Internist, or a Family Medicine doctor will be the one who knows the patient the most. They put together and decide on the recommendations of the physicians above.
  18. Other specialties that a T2D may see will be gastroenterologists, rheumatologists, psychiatrists, rehabilitation medicine physicians, and hematologists.

At present, many states, counties, and hospitals already have doctor shortages. Many doctors are overworked. The waiting rooms in the Emergency Department are always full of patients, and some hospitals do not have all the specialists.

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Getting an outpatient appointment now may take months. That is, if they will accept your insurance. If there is no insurance coverage, be ready to spend a lot. An ER visit can cost thousands.  A week in an intensive care unit can go up to six figures if you have no insurance coverage.

Genetics and aging have a small role, but lifestyle is a significant factor in metabolic syndrome,  obesity, type 2 diabetes, and complications. Intermittent fasting and exercise play an essential role in Type 2 diabetes control and possible reversal.

Don’t Get Sick.

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Related Readings:

  1. What is Insulin Resistance?
  2. Hyperinsulinemia
  3. What is the Goal of Diabetes Treatment?
  4. I’m Only Pre-Diabetic, So I’m Still OK, Right?
  5. Prescriptions that Promote and Pharmaceuticals that Prevent Ischemic Preconditioning
  6. Nitric Oxide in Medicine
  7. Reactive Oxygen Species
  8. High Blood Sugar, Even for a Short Period, Causes Atherosclerosis
  9. A Common Type of Anemia can Affect your Diabetes Test
  10. Drugs that Cause Insulin Resistance
  11. What is Insulin Resistance?

Reference

American Association of Medical Colleges

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