Health services, not doctors, in short supply, Harvard author says

The Harvard Business School author who developed a theory of disruptive innovation thinks there is no shortage of doctors, in primary care or other specialties.

Writing in a commentary on CNN.com, Clayton M. Christensen and Dr. Jason Hwang of the Innosight Institute, the Watertown think tank they founded, respond to calls to increase medical school enrollment and change how doctors are paid as part of overhauling the US healthcare system.

"There IS a shortage of health care services being provided, but many of them are not best offered by a doctor," they write.

They point to high satisfaction rates at retail clinics that offer care by nurses for a short list of uncomplicated problems. In a similar vein, they say services delivered by specialists may be performed by primary care doctors, thanks to disruptive innovations in the form of better technology. One example they give is is new technology that makes it easier for non-anesthesiologists to administer conscious sedation.

"By moving more complex care from specialists to primary care providers, the payments will follow," they write. "These changes would make primary care more fulfilling and financially rewarding, while freeing up specialists to do even more complicated work that merits their additional training."

Virtual office visits and online house calls can smooth out the uneven distribution of healthcare between rural and urban parts of the country, they say.

"Rather than calling for more doctors, which would have been difficult for the government to impact anyway, what the country really needs are policies that pave the way to more avenues of care, which is well within the government's control," Christensen and Hwang write.