Name: 缺少 187130 名醫生 📉 （這對未來醫生意味著什麼？） (187,130 Doctors Short 📉 (What This Means for Future Docs))
Uploaded: 2025-09-25T19:10:00.000Z
Duration: 10 min 34 s

Dr. Patel's shift ended 3 hours ago, but she's still at the hospital, charting, returning calls, doing the work of 3 people.

帕特爾醫生的班在 3 小時前就已經結束了，但她仍在醫院裡做病歷、回電話，做著 3 個人的工作。

程度副詞

One colleague just quit, another's out on stress leave, and there's no replacement in sight.

一位同事剛剛辭職，另一位正在休壓力假，而目前還沒有替代人選。

This wasn't what she signed up for, she wanted to care for people, not be worn down by the tedious minutiae of a bureaucracy in shambles.

這不是她簽約的初衷，她想要的是關愛他人，而不是被一個破敗不堪的官僚機構中乏味的瑣事所拖累。

And it's not just her, this is happening in hospitals across the country.

不僅是她，全國各地的醫院都出現了這種情況。

Because the truth is, we're running out of doctors, and it's about to get worse.

因為事實是，我們的醫生已經不多了，而且情況會越來越糟。

Dr. Jubbal, MedSchoolInsiders.com, we're staring down the barrel of a massive physician shortage in the US, an estimated gap of 187,000 doctors by 2037.

Jubbal博士，MedSchoolInsiders.com，我們正面臨著美國大規模的醫生短缺問題，預計到2037年將出現18.7萬名醫生的缺口。

That's not just a staffing issue, that's a public health crisis in slow motion.

這不僅是一個人員編制問題，更是一場慢動作的公共衛生危機。

So what's driving this shortage, and what does it mean for the future of medicine?

那麼，是什麼導致了這種短缺，它對醫學的未來又意味著什麼？

The doctor shortage isn't just a prediction, it's already here.

醫生短缺不只是一種預測，它已經到來。

In 2017, experts were warning about the impending shortage of doctors.

2017 年，專家們曾警告醫生即將出現短缺。

Last year, the AAMC projected we'd be short over 100,000 physicians by 2030, which is right around the corner.

去年，美國醫學會（AAMC）預計，到 2030 年，我們將缺少超過 10 萬名醫生。

But what's even more alarming is the latest projection.

但更令人擔憂的是最新的預測。

By 2037, that shortage could nearly double, and this deficit is spread across almost every specialty in medicine.

到 2037 年，這一缺口可能會增加近一倍，而這一缺口幾乎遍佈醫學的每一個專科。

Now a quick caveat here, counterpoints suggest agencies like the AAMC might be incentivized to inflate these numbers, and other organizations may have more conservative estimates.

這裡有一個簡單的說明，反方觀點認為像美國醫學會這樣的機構可能會受到激勵而誇大這些數字，而其他組織可能會有更保守的估計。

But even if you take a more conservative view, the projected shortage is still an undeniable crisis.

但是，即使採取更保守的觀點，預計的短缺仍然是一個不可否認的危機。

Primary care is going to take the hardest hit.

初級保健將受到最嚴重的打擊。

By 2037, we could be short 87,000 primary care doctors.

到 2037 年，我們可能會缺少 87000 名初級保健醫生。

Critical specialties such as OBGYN, cardiology, and anesthesiology are also facing shortages.

婦產科、心臟科和麻醉科等關鍵專科也面臨人才短缺問題。

Longer wait times, delayed diagnoses, and more people being forced to go without care, especially in rural areas.

等待時間延長，診斷延誤，更多的人被迫得不到治療，尤其是在農村地區。

Entire communities could become medical deserts where access to even basic healthcare is a luxury.

整個社區都可能成為醫療沙漠，在那裡，即使獲得基本的醫療服務也是一種奢侈。

By 2037, rural areas will be short 60% of the physicians they need compared to just 10% in cities.

到 2037 年，農村地區所需的醫生將短缺 60%，而城市僅為 10%。

Right now, as we speak, 76 million Americans are currently living in primary care deserts, and most of them are in rural communities.

現在，就在我們發言的時候，有 7600 萬美國人正生活在初級保健荒漠中，其中大多數人生活在農村社區。

那麼，我們是如何陷入這種困境的呢？

不幸的是，這不僅僅是一個因素。

By 2030, every single baby boomer will be 65 or older.

到 2030 年，每個嬰兒潮一代都將達到或超過 65 歲。

As people age, they require more healthcare, typically for more complex and long term conditions.

隨著年齡的增長，人們需要更多的醫療保健服務，通常是針對更為複雜和長期的疾病。

The number of people aged 75 and older is expected to grow by 55% by 2036.

預計到 2036 年，75 歲及以上人口的數量將增長 55%。

And it's not just the patients getting older, it's the doctors too.

不僅是病人在變老，醫生也在變老。

Nearly half of all practicing physicians in the US are already over 50 years old, and 1 in 5 are over 65.

美國近一半的執業醫生年齡已超過 50 歲，每 5 人中就有 1 人超過 65 歲。

That means a huge wave of retirements is right around the corner, shrinking the number of available doctors just as demand is exploding.

這意味著一大波退休潮即將來臨，就在需求激增的同時，可用醫生的數量也在減少。

Back in the 80s, we were actually worried about a doctor surplus.

早在上世紀 80 年代，我們就曾擔心過醫生過剩的問題。

That led to the 1997 Balanced Budget Act, which capped the number of residency slots funded by Medicare.

這導致了 1997 年《平衡預算法》的出臺，該法對醫療保險資助的住院實習名額設置了上限。

And those caps are still in place today, creating a huge bottleneck in the pipeline of new doctors.

而這些上限至今仍然存在，給新醫生的培養造成了巨大的瓶頸。

Every year, hundreds of qualified medical school graduates get stuck in limbo because they can't secure a residency spot to complete their training.

每年都有數百名合格的醫學院畢業生因無法獲得住院醫師培訓名額而陷入困境。

After being handed a medical degree, they're told, sorry, you can't work yet.

拿到醫學學位後，他們被告知，對不起，你還不能工作。

Additionally, specialized residency programs and fellowships are heavily concentrated in

此外，專門的住院醫師培訓計劃和獎學金主要集中在以下地區

Yet 18% of Americans reside in rural areas, where only 2% of Medicare-funded residency slots are available.

然而，18% 的美國人居住在農村地區，而那裡只有 2% 的醫療保險資助的住院醫生名額。

This further hinders underserved areas where the need is greatest.

這進一步阻礙了需求最大的服務不足地區的發展。

The next contributing factor is the cost of becoming a doctor.

第二個因素是成為醫生的成本。

The average medical student graduates with over $260,000 in debt, a significant financial burden even with a high-earning career ahead.

醫科學生畢業時平均負債超過 26 萬美元，即使未來的職業生涯收入很高，這也是一個沉重的經濟負擔。

And while many physicians can manage and pay off this debt over time, especially with smart financial planning, keep in mind that $260,000 is only the average.

雖然許多醫生可以管理並在一段時間內還清這些債務，尤其是通過明智的財務規劃，但請記住，26 萬美元只是平均值。

Many graduates face upwards of $400,000 in debt, particularly if they attended private institutions.

許多畢業生面臨高達 40 多萬美元的債務，尤其是在私立學校就讀的學生。

For someone considering medicine, that kind of debt can feel daunting, to say the least, especially if you're from a lower-income background or want to go into primary care, which pays less than other specialties.

對於考慮從醫的人來說，這樣的債務至少可以說是令人生畏的，尤其是如果你來自低收入背景或想從事初級保健，因為初級保健的薪酬比其他專業要低。

If that wasn't enough, there's more trouble ahead.

如果這還不夠，前面還有更多麻煩。

Earlier this year, House lawmakers proposed capping direct unsubsidized loans at just $150,000 as part of a broader reconciliation package, which is nowhere near enough to cover the full cost of medical school for many students.

今年早些時候，眾議院立法者提議將直接無補貼貸款的上限設定為 15 萬美元，作為更廣泛的和解方案的一部分。

These same proposals have also targeted key loan forgiveness programs, suggesting the elimination of Public Service Loan Forgiveness, or PSLF, eligibility for medical residents.

這些提案還針對主要的貸款減免計劃，建議取消公共服務貸款減免（或 PSLF）對醫學住院醫師的適用資格。

While these remain proposed changes that face significant legislative hurdles and haven't been enacted, the uncertainty alone is already impacting prospective medical students.

雖然這些擬議中的改革仍面臨著巨大的立法障礙，尚未頒佈實施，但單單是不確定性就已經對未來的醫學生產生了影響。

It's also worth noting that part of why college and medical school tuition has gotten so out of hand is because students have historically been able to take out essentially unlimited federal loans.

值得注意的是，大學和醫學院的學費之所以如此失控，部分原因在於學生歷來可以無限制地申請聯邦貸款。

With the government footing the bill, there's been little to no market pressure on schools to keep costs in check, and they've capitalized on that.

有了政府的買單，學校幾乎沒有了控制成本的市場壓力，他們也就利用了這一點。

Time will tell if capping loans has the intended effect of reducing tuition for college and medical school, or if it simply prices out those without affluent parents footing the bill.

時間會證明，設定貸款上限是否能達到降低大學和醫學院學費的預期效果，抑或只是讓那些沒有富裕父母買單的學生望而卻步。

In fact, in July 2025, the Department of Education concluded sessions focused on restoring aspects of PSLF, demonstrating the current fluidity of these policies.

事實上，在 2025 年 7 月，教育部結束了以恢復 PSLF 的各個方面為重點的會議，表明了這些政策目前的流動性。

Even the possibility of these changes creates uncertainty and additional barriers for future doctors, particularly the many students who rely on loans to pay for medical school.

即使可能出現這些變化，也會給未來的醫生，尤其是許多依靠貸款支付醫學院學費的學生帶來不確定性和更多障礙。

I cover the uncertainty of medical student loans in much more detail over on the Kevin

我在 Kevin 網站上更詳細地介紹了醫學生貸款的不確定性。

Jubbal, MD channel, link in the description.

Jubbal, MD 頻道，鏈接在說明中。

Now, what happens if this shortage continues unchecked?

現在，如果這種短缺繼續得不到控制，會發生什麼情況呢？

We don't even have to speculate, we're already seeing the impact.

我們甚至不用猜測，就已經看到了影響。

Longer wait times, misdiagnoses, and far too many people being forced to go without even basic care.

更長的等待時間、誤診以及太多的人被迫得不到基本的治療。

And, once again, it's rural areas that are being hit the hardest.

農村地區再次受到最嚴重的打擊。

Entire labor and delivery units are shutting down, forcing women to travel massive distances to give birth.

整個分娩室都關閉了，迫使婦女長途跋涉去分娩。

And, let's not forget the mental health crisis.

Behavioral health services are already in short supply, and with fewer doctors, it's only going to get worse.

行為健康服務已經供不應求，隨著醫生數量的減少，情況只會更糟。

Coming as no surprise, studies show that areas with fewer doctors have lower life expectancy and higher rates of chronic illness.

毫不奇怪，研究表明，醫生較少的地區預期壽命較短，慢性病發病率較高。

Which brings me to another uncomfortable truth.

這讓我想到了另一個讓人不舒服的事實。

The US spends far more per capita on healthcare than any other high-income country.

美國的人均醫療支出遠遠高於其他高收入國家。

Last year alone, healthcare spending in the US hit a whopping $5 trillion, or nearly $15,000 per person.

僅去年一年，美國的醫療開支就高達 5 萬億美元，人均近 15000 美元。

Ranking dead last on many key health indicators.

在許多關鍵健康指標上排名倒數第一。

In fact, our average life expectancy is more than 4 years below the 10-country average, behind countries like Canada, France, and Germany.

事實上，我們的平均預期壽命比 10 個國家的平均水平低 4 歲多，落後於加拿大、法國和德國等國家。

We're spending the most, and yet we're dying sooner and living less healthy lives.

我們花的錢最多，卻死得更早，活得更不健康。

Are doctors to blame for astronomically high healthcare costs?

天文數字般的高額醫療費用是醫生造成的嗎？

We broke down the truth about healthcare spending in a previous video, link in the description.

我們在之前的視頻中分析了醫療支出的真相，鏈接在描述中。

And the doctors still in the system are overwhelmed.

而仍在系統中的醫生們已經不堪重負。

Workloads are increasing, hours are longer, and burnout rates are rising.

工作量在增加，工作時間在延長，倦怠率在上升。

The more stress doctors face, the more likely they are to leave the field, and the harder it becomes to attract new talent.

醫生面臨的壓力越大，他們就越有可能離開這個領域，也就越難吸引到新的人才。

And tragically, the stress is taking a heavy toll.

不幸的是，這種壓力正在造成嚴重損失。

Physicians have one of the highest rates of burnout and depression among any profession, with 300-400 doctors taking their own lives each year.

醫生是職業倦怠和抑鬱症發病率最高的職業之一，每年有 300-400 名醫生自殺。

Now that we understand the mess we're in, what can we do to fix it?

既然我們已經瞭解了我們所處的困境，那麼我們該如何解決呢？

One of the most critical areas for reform is graduate medical education, or GME.

改革的最關鍵領域之一是畢業後醫學教育（GME）。

我們需要擴大住院醫師培訓的規模。

That means lifting the cap on Medicare-funded slots and investing in training programs in rural and underserved areas.

這意味著取消醫療保險資助名額的上限，並對農村和服務不足地區的培訓計劃進行投資。

Congress has added 1,200 new GME slots since 2021, the first increase in decades, but that barely scratches the surface.

自 2021 年以來，美國國會新增了 1200 個普通高等教育名額，這是幾十年來的首次增長，但這僅僅是表面現象。

But broader efforts on residency reform haven't made much progress.

但更廣泛的居住地改革工作卻沒有取得多大進展。

Take, for example, the 2014 Institute of Medicine report.

以 2014 年醫學研究所的報告為例。

It recommended shifting residency funding toward value-based care rather than the traditional fee-for-service model.

它建議將住院醫師資助轉向以價值為基礎的護理，而不是傳統的收費服務模式。

But like many healthcare reforms, it was ultimately blocked by political resistance and powerful interest groups.

但與許多醫療改革一樣，它最終也受到了政治阻力和強大利益集團的阻撓。

We break down the difference between value-based and fee-for-service care in a previous video, link in the description.

我們在之前的視頻中分析了基於價值的醫療服務和收費醫療服務之間的區別，鏈接在描述中。

We also need to make med school affordable again.

我們還需要讓人們再次負擔得起醫學院的學費。

That means protecting loan forgiveness programs like PSLF, expanding service-based scholarships, and increasing support for students from socioeconomically disadvantaged backgrounds.

這意味著要保護像 PSLF 這樣的貸款減免計劃，擴大基於服務的獎學金，並增加對來自社會經濟弱勢背景的學生的支持。

We also need to rethink how we compensate doctors.

我們還需要重新思考如何補償醫生。

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缺少 187130 名醫生 📉 （這對未來醫生意味著什麼？） (187,130 Doctors Short 📉 (What This Means for Future Docs))

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massive

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