Health Care Bill Creates Shortage of Primary Physicians
The historic signing of the health care bill on Tuesday has left Obama administration officials searching for a way to increase the shortage of primary care physicians. Now that 32 million more people, who were once uninsured, have been added to the health care system, there seems to be a few problems that have arisen. How do family physicians plan to cope with the influx of so many new patients?
Primary care providers are the main source of health care for most Americans, and since many medical students aren’t choosing to go into primary care, more Americans will encounter trouble attempting to see their doctor.
“I always thought I would go into primary are just because that’s what’s needed, but after learning about different specialties, primary care didn’t excite me as much. And I’ve realized that you can still do the job of helping others without being in primary care,” said Brandon Henry, a first year medical student at Howard University
In order to cope with the growing shortage of primary care physicians, federal officials are developing several proposals, one of which would increase enrollment in medical school and residency training programs. Another would encourage a greater use of nurse practitioners and physician assistants. A third option would expand the National Health Service Corps, which deploys doctors and nurses in rural areas and poor neighborhoods. Celia Maxwell, a physician at Howard University Hospital agrees.
“We know that there is a shortage of primary care doctors and that will present a great challenge with an influx of patients in that that there will not be enough man power to handle it right off, but everyone will not roll on at the same time. It will be phased in and so we have the opportunity to train people including physician extenders, nurse practitioners, and physician assistants to help deal with the capacity that we don’t have… It won happen over night. We might also have to start training people in such a way that might not be traditional.”
It’s clear that there’s a shortage of primary care physicians, but the big question here is why?
Most medical students are in pursuit of a degree in some sort of specialty because of the higher pay as opposed to primary care which results in longer work days, lower pay, and less prestige.
“I’m interested in pediatrics and I understand that it’s the lowest paying job, but you’re out to do something that you love, the money doesn’t really matter,” said Howard University medical student Rashonda Dennis.
The number of medical school students in the United States going into primary care has dropped almost 52 percent since 1997, according to the American Academy of Family Physicians (AAFP). The AAFP is predicting that there will be a shortage of 40,000 primary care physicians in 2020, when the demand is expected to be at its highest. Currently, the Unite States health care system has about 100,000 primary care physicians and will need approximately 140,000 in the next 10 years.
With such a shortage of family physicians, finding a doctor will become increasingly difficult, waits for appointments will grow longer, and more sick people will resort to crowded emergency rooms. In some instances patients may visit their doctor’s office and may not be treated by their doctor.
The Medicare Payment Advisory Commission, an independent federal panel, has recommended an increase of up to 10 percent in the payment for many primary care services including office visits. Congress is also looking at bills that could help doctors who choose primary care with loan forgiveness or other debt relief and payment increases for their services. Obama also wants to expand the National Health Service Corps, which helps medical students pay tuition in return for two to four years of service in communities that do not have enough doctors.
Most medical school students’ tuition and expenses generally range from $140,000 to $200,000, according to Merritt Hawkins & Associates, a leader in recruiting and placing physicians. A primary care doctor usually earns $120,000 to $190,000 a year, compared with $530,000 and higher for those who plan to
In Washington there are 248 primary-care physicians per 100,000 residents, 113 for Maryland and 88 for Virginia, while the national average is 88 doctors per 100,000 people. As for waiting times, the average wait to see a family physician is 30 days and Washington is ranked as the third city with the longest wait times.
A study by the Robert Graham Center and the National Association of Community Health Centers concluded that 15,585 more primary-care providers would be needed in order for health centers to serve 30 million new patients