I have been saying to whoever will listen to me (which is nobody) for years now that the way we treat health care a decade from now will be vastly different than the way we treat health care now.  One of the points that I rant about often is the upcoming “doctor shortage”.  Now I have a study to point to that shows that what I have been saying is true; there is no doctor shortage.

The main problem with studies claiming that there is a doctor shortage is that they take the current health care system as a baseline and extrapolate it to the future.  This is almost assuredly a false model.  The baseline, in this case, being one doctor, one practice.  That has been changing rapidly, though.

Even now, we’re approaching three doctors, one practice.  Instead of having one doctor that always sees you, you end up with one of the three doctors whichever happens to be available.  There are great logistical savings with this model.  The amount of patients that can be seen rises dramatically.  The amount of time sitting in a paper gown waiting for a doctor to show up decreases dramatically too.

But that’s not the only advance that is around the corner.  We are also becoming more dependent on nurses for everyday health care needs.  If we assume that, in the future, 20% of our needs will be met by nurses, the doctor shortage completely disappears.  I like this number because it’s conservative.  I could easily see 40% or even 50% of our health care needs being provided by nurses in the future.

As pointed out in the article by someone who has a vested interest in declaring a doctor shortage, there is still the issue of specialists.  I don’t know enough about this to give an educated answer.  I’m guessing, though, that specializations like neurosurgery will be quickly taken over by robots.  Advances in remote surgery are already ready for prime time so replacing the doctor completely seems the next logical step.  I, for one, would feel much safer with a precision robot rooting around in my brain than a human that may be a little jittery because they had too much caffeine.

One of the more promising paths to health care savings pushed by Obamacare was the migration from paper based records to electronic records.  Unfortunately, it looks like health care providers are not moving to electronic systems nearly as fast as predicted.

Such a shame.  Electronic records will eventually be the future.  It’s just going to take much longer than anticipated to get there.  There are many reasons for this.

Primary among them, in my opinion, is a lack of standardization.  The whole idea of savings related to electronic records is the simple exchange of information from one doctor’s office to the next and to the hospital and to the pharmacist and to the specialist.  So instead of many different offices having many different records, you have one set of electronic records that is shared among them.  The problem we are seeing is that doctor’s office A implements one system and doctor’s office B implements another system and system A can’t talk to system B.  So we end up spending millions of dollars to implement these systems and they end up being no better than the paper system.

This is where governmental standardization would be ideal.  Let the private market create as many electronic record keeping systems as they want, but mandate that the data will be stored exactly the same way regardless of the system.  Insurance information will be stored like X.  CAT scans will be stored like Y.  Blood tests will be stored like Z.

Think of the health care system like infrastructure.  Health records are like roads.  The government controls how they are built.  All of the health care providers are connected to the roads.  The roads can take you anywhere you need to go.

Of course, I recognize that this is pie-in-the-sky thinking.  The guvmint can’t be trusted to do anything including govern.  Or so they say.  Really, though, this is the path we need to take for the promised savings.  It’s a shame we’ll never take it.