The US health care system is a topic of great concern, with insurers often cast as villains and doctors facing various challenges. This article delves deep into the experiences of US doctors, exploring the factors that contribute to their stress, burnout, and the high cost of medical education. It also examines how these issues impact the overall quality and cost of the health care system.

Uncovering the Hidden Struggles of US Doctors in the Health Care Crisis

Many US Physicians are Tired and Stressed

Once, US doctors were the community's fulcrum, but now they face a different reality. Some young physicians feel they've missed out. A study showed that the number of burned-out doctors grew from 44% in 2017 to over 50% in 2021, with primary care doctors experiencing particularly high burnout rates. Traveling to other countries, we find that doctors there face similar challenges but also have different issues. In the US, the misallocation of doctors due to the high cost of medical education leads to a shortage of family doctors.Even before getting their MDs, US doctors face obstacles. The length of training and the associated debt make becoming a doctor very expensive. In contrast, in countries like the Netherlands, Australia, and Taiwan, doctors have a more manageable financial burden.

Medical Education in the US is Really Expensive

US medical professional societies set high standards for training and licensing, making the quality of health care world-class. However, this comes at a high cost. US doctors attend four years of undergraduate college and four years of medical school, followed by a three to seven-year residency with no full-time salary. It can take up to 15 years and cost up to $500,000 in tuition, with most graduating with over $200,000 in debt.In other countries, the financial burden is much less. Dutch doctors take three years of undergraduate and three years of master's studies, with a one- to two-year internship before licensing. Australian doctors have a similar education path but with lower tuition costs. Taiwanese doctors also spend significantly less on education. These countries have more robust public support for higher education and generous loan repayment programs.

The US Health System Forces Doctors to Do So Much Paperwork

The US health system places a heavy burden on doctors through health insurance paperwork. As left-leaning policy analyst Matt Bruenig pointed out, excess pricing of medical services can be attributed to administrative costs. The demands of insurance claims take doctors' time and attention away from patients, leading to worse health outcomes.According to the Commonwealth Fund's 2024 international survey, 20% of US doctors spend "a lot" of time on paperwork or disputes over medical bills, nearly double the rate in other countries. Only 5% of Dutch doctors and 9% of Australian doctors have the same issue. This wasteful activity affects both the cost and quality of the health system, with US patients having the fewest consultations and spending the least time with their physicians.

American Doctors do Make a lot of Money

Fixing college and post-college education costs is challenging, so the US solution to doctor debt is to offer high salaries. The average physician salary in the US ranges from $260,000 to $550,000, with some elite providers earning over $1 million annually. In contrast, Dutch general practitioners make about $126,000, and senior hospital surgeons earn about $250,000. In Australia, primary care doctors earn between $60,000 and $93,000, and specialized surgeons can make up to $460,000. Taiwanese doctors make between $60,000 and $100,000 per year, but they feel underpaid compared to the number of patients they see.Doctors in these countries also have their own complaints. Dutch primary care doctors have gone on strike for better pay, and Australian physicians face a dilemma between public duty and private sector earnings.

Doctors can Help Make a Better Health Care System

The blame game between insurers and doctors is a distraction. Other countries have similar systems but don't have the same issues. The US needs to address the entire system, including prices and reimbursement. US physicians have legitimate gripes, but they also need to be aware of the global context.The profession needs to accept some changes. Expanding "scope of practice" policies could save money without sacrificing quality. Physician trade associations often oppose these changes, showing how they help preserve flaws in the system.The path forward is to make it easier for doctors to charge affordable prices and address the comprehensive issues in the health care system. Both providers and patients are tired of the current situation, and the US must find ways to fix it.