The predicted physician shortage in the United States has been receiving a significant amount of attention by mainstream media outlets as of late. While not a new concern, the 2010 passage of the Affordable Care Act (ACA) cast a new light on the issue. A lively debate exists as to whether the ACA will have an impact on the shortage beyond what has already been forecasted.
As alluded to above, many claim that the ACA will not have a significant impact on the shortage, as these individuals have been seeking care, albeit at different frequencies and in different settings than most insured individuals. Proponents of this theory claim that any shortage is due to a number of different reasons, including population growth, aging, the cost of a medical education, the number of residency slots, reimbursement rates, physician compensation discrepancies – the list goes on and on. Others claim it is not a shortage issue at all, rather a distribution issue, with an over-abundance of physicians in metropolitan areas and a gross scarcity in rural America.
Nonetheless, the fact remains that approximately 30 million additional Americans will have access to health insurance within the next few years. That fact begs the question “are there enough physicians to see us all?”
While the physician shortage is anticipated to span multiple specialties, primary care physicians are receiving the most attention. Rightfully so, as primary care physicians are more often than not the entry point to access other specialties. Alarmingly, industry associations estimate that the shortage of primary care physicians will rise to between 52,000 to 160,000 by 2025. The United States is also expected to experience a shortage in general surgeons.
Many have tossed around ideas to address this shortage. These suggestions include adopting the patient-centered medical home, putting more focus on developing National Health Service Corps sites, encouraging and supporting mid-level providers, addressing the costs of a medical education, and developing incentives to medical students to begin careers in primary care and general surgery.
The ACA also took some steps to promote primary care-related issues. Specifically, the ACA authorized money to increase the number of primary care physicians by training more physicians, nurse practitioners, physician assistants, and midwives, increasing the number of scholarships and loans for all health professionals, and implemented a 10% bonus, through 2015 to primary care physicians who offer services to Medicare patients to name a few.
Whether the AACA will have a true impact on the practice of primary care physicians is yet to be seen. Nonetheless, the industry’s response to the issue will affect the practice of medicine for years to come.
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