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How The U.S. Can Prepare For The Next Pandemic


Now that we've talked about some of the warning signs leading up to this moment, we're now going to look forward. Dr. David Skorton is the president and CEO of the Association of American Medical Colleges, and he's been thinking about the ways the U.S. should prepare for the next pandemic. And while it may seem early to be planning for the next public health crisis while we are still in the middle of this one, Skorton says we have no time to waste. And Dr. David Skorton is with us now from his home office in Washington, D.C.

Dr. Skorton, thanks so much for talking to us.

DAVID SKORTON: Michel, thanks for having me on.

MARTIN: And I just want to mention, you've published a piece in USA Today that lists five steps the U.S. should take right now. And the first thing you say is to assign the highest level of urgency to the strategic national stockpile of essential supplies - drugs, medical devices such as ventilators. I think people will have heard about this now because of the current crisis. But you're saying that the stockpile has long been depleted and that critical machines like ventilators haven't been maintained. Why is that?

SKORTON: Well, you know, it's very, very hard to think about eventualities when you're dealing with everyday crises in our lives day in and day out. There's always something that's higher priority than thinking about the future. But we make a mistake by not thinking about the future enough.

And I believe there's three things that have to happen with the strategic national stockpile. We need to prioritize it, we need to fund it appropriately and we need to maintain it. We need to be sure that what's in there is up to date or if it has to be updated, it is updated and not wait until we're in the teeth of a pandemic or some other crisis to find out we're not ready to go.

MARTIN: Congress has, though, just provided funding to increase the stockpile through the stimulus package that just passed, the CARES Act. In your opinion, is that enough? Is the issue funding, or is the issue management?

SKORTON: The answer to that, A or B, is yes, it's both. And it's very, very important that we have the appropriate funding and that that funding be stable, just like it's important for other areas like research. But it's also important that the management is forward-looking. And there are some very, very good people running and overseeing the SNS. But it's important to put the right funding and the right priority in their hands.

MARTIN: You say that there are predicted long-term shortages in the health care workforce. We just need more doctors - and not just primary care physicians, but specialists in all these critical areas. This is something I think might be news to a lot of people. You said that the number of doctors enrolling in U.S. medical schools has increased by 30% over the past 15 years, but we still need to increase support of graduate medical education like residency training so we can increase the number of practicing physicians.

Well, first of all, the same question - why is there this shortage to begin with? It's just the - this - kind of the generational turnover? And what can be done to get more people into the pipeline quickly?

SKORTON: Well, the generational turnover that you talk about when people my age, the boomers, retire, we're going to have even a worse problem. And that's why the organization I work for, the Association of American Medical Colleges, has been trying to project what the shortage might look like.

And just as you said, Michel, it's not just primary care. It's also many specialties. But the United States for a long time has had a lower ratio of physicians per capita - that is, physicians to citizens - than many other countries in the OECD. That's been true for a couple of decades that I've been aware of. We really haven't made much progress in there.

Although it is true that we have 30% more enrollees in medical school than we had just a short time ago, but just as you also mentioned, we need to make sure that they have enough slots to go into graduate medical education and therefore can come out the other end with either primary care credentials or specialty credentials and then be out there to serve the public.

MARTIN: But before we let you go, is there a big change you hope to see overall as a consequence of this crisis? I mean, as - one of the things that a lot of people have noted is that this has brought things to light that were already there (laughter). And that's part of what your piece is talking about. But is there overall some change that you would like to see - the way we think about health care, some change in the system overall that you would point us to?

SKORTON: One is, I hope we pay more attention to vulnerable populations, to our neighbors who are homeless, who have other kinds of very, very challenging socioeconomic circumstances. When we say shelter in place, you have to have a place to shelter for that to happen. And I'm very, very concerned about vulnerable populations. And I hope that we take even a more serious look at that in our great cities and also in rural areas as soon as we possibly can. That's one.

And secondly, I think it's very, very important that we think about the role of immigrants - and I'm thinking about the DACA rescission that's possibly going to happen. I want to leave your listeners with one more statistic. Roughly 27,000 health care workers across the United States, doctors and others, would lose their authorization to work if DACA is rescinded. And so I hope we think more broadly about vulnerable populations, about immigrants who add so much to our country as well as the other issues inside the piece.

MARTIN: That was Dr. David Skorton. He's the president and CEO of the Association of American Medical Colleges.

Dr. Skorton, thanks so much for talking to us today.

SKORTON: Thanks, Michel. Thanks very much.

(SOUNDBITE OF CAT CLYDE'S "MAMA SAID") Transcript provided by NPR, Copyright NPR.

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