'Silent Shortage' Of Psychiatrists growing in the U.S.

Reflecting the frustrations of modern medical practice, a full quarter of psychiatrists said they would not choose medicine if they could decide their career paths all over again.

The web-based survey was conducted in 2005 by physician recruiting firm LocumTenens.com. Compared to locum tenens industry studies asking the same question of physicians across a range of specialties, LocumTenens.com's 2005 figure represents an increase of 20 percent since 1997.

The current state of U.S. healthcare has benefited physician recruitment firms increasingly over the past several years. Pushed into a corner by trends like higher insurance costs and more aggressive third-party payers, more and more physicians want to get out of medical practice.

This trend has helped 10-year-old LocumTenens.com increase revenue by 600 percent over the last five years (2000 to 2005), says LocumTenens.com’s Executive Vice President Michael Davis.

"Reimbursement is a huge problem which has forced changes in the way psychiatry is practiced," Davis says.

According to data collected by the American Psychiatric Association's (APA) Office of Research in 2004, a psychiatrist can earn about 57% more from three 20-minute medication management visits than from a one-hour outpatient psychotherapy visit. This has resulted in psychiatrists seeing more patients, and spending less time with each. The APA's 2004 annual meeting had concluded that psychiatric workforce trends were leading to healthcare access problems.

Given this scenario, a “silent shortage” of psychiatrists has been growing in the U.S. over the past decade or so. According to the AMA reports, the supply of U.S. psychiatrists shrank 27 percent between 1990 and 2002. Meanwhile, demand increased by 16 percent over that same time period.

The aging of the psychiatrist population is adding to the problem of decreasing access. Almost half (46 percent) of the 40,000-plus U.S. psychiatric population is 55 years or older, compared to approximately 35 percent of all U.S. physicians.

Meanwhile, demand is increasing. The U.S. Bureau of Health Professions projects that between 1995 and 2020, demand will increase by 100% for child and adolescent psychiatrists and by 19% for generalists.

In an encouraging sign, the American Association of Medical Colleges' (AAMC) National Resident Matching Program reports increased interest in psychiatry residencies. An AAMC news release said in March 2005, "For the fourth consecutive year, there has been an increase in the number of first-year positions offered and filled by U.S. medical school seniors."