Doctor And Nursing Shortage Could Undermine Health Care Reform

A shortage of doctors and nurses could damage health care reform. Analysis finds that more incentives are needed for primary care doctors and that most medical graduates choose better paid specialties. Meanwhile, a nurse temp agency forms in Texas to address the shortages there.

Reuters reports: "A growing shortage of primary care doctors could place a major burden on the U.S. healthcare system if President Barack Obama succeeds in extending medical insurance to millions of Americans who currently lack it. As healthcare legislation works its way through the U.S. Congress, most of the focus has turned to how to finance a reform that could cost $1 trillion in the next 10 years and aims to cover most of the 46 million uninsured Americans. Less attention has been paid to what might happen if millions of new patients join a healthcare system that is unprepared and unequipped to handle the load. The United States already has a shortage of between 5,000 and 13,000 primary care doctors, according to the Robert Graham Center. Add millions of previously uninsured people and the shortfall will balloon to as many as 50,000 doctors."

Dr. Cecil Wilson, president-elect of the American Medical Association, said "the country needs more medical schools, more residency slots, and better pay for primary care physicians who currently make much less money than specialists." Reuters notes: "Insurers routinely pay more for procedures performed by specialists than for checkups by primary care doctors. A primary care physician typically earns between $125,000 and $200,000, while specialists often earn several times more."

Meanwhile, some experts argue the problem is more an inefficient healthcare system including that poor areas are underserved. Reuters reports: "The Altarum Institute, another non-profit group that analyses medical policy, found affluent areas of cities tend to have plenty of primary care physicians, while poor urban areas and rural regions are underserved. There is also a perceived shortage of nurses, who may be called upon to take on more tasks when preventive care becomes the norm. Congress is weighing incentives for primary care physicians, such as bumping up payments for primary care services by 5 percent from the government-run Medicare program, and writing off medical school debt in exchange for service in the National Health Service Corps, which places doctors in underserved areas."  However, expanding the number of primary care doctors could take years. Reuters notes: "Primary care doctors -- family physicians, pediatricians, and general internists -- comprise one-third of the 682,000 U.S. doctors, about the same proportion as two decades ago, but their numbers are seen dwindling as retirees are not replaced" (Stern, 7/23). 

Meanwhile, the Dallas Morning News reports: "Texas Health Resources Inc., the largest hospital system in North Texas, said Wednesday it has formed a temp agency with an Arlington-based medical staffing company to both save money and fix its nursing shortage. The joint venture with Medfinders Inc., operating as Texas Health SingleSource Staffing, will oversee the staffing of all per-diem nurses for Texas Health's 14 hospitals across North Texas. By having an in-house agency, Texas Health is better able to fill its 5 percent nurse vacancy rate and avoid costly overtime by paying temporary nurses to cover shifts of full-time nurses, said Joan Clark, chief nursing executive and senior vice president of Texas Health Resources. The working habits of the younger generation of nurses also spurred Texas Health's joint venture, Clark said. Many nurses now prefer to travel and see other parts of the country rather than be tied to a single hospital. Texas Health's staffing company is seeking to hire such nurses for assignments with the lure of ultimate flexibility."

The paper notes: "The state is experiencing one of the country's worst nursing shortages, with a projected deficit of 30,242 nurses by the year 2015, according to the federal Health Resources and Services Administration" (Roberson, 7/23).

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