Physician Shortage Could Grow Under New Health Law

News outlets report on how primary care might be impacted by the new health law.

HealthDay/Bloomberg BusinessWeek: With tens of millions of patients newly insured under the law, "[s]ome experts worry that there could be longer wait times to see a doctor, particularly in rural areas and underserved markets where primary-care physicians are in short supply. … [P]rimary-care physicians make up only 35 percent of America's physician workforce, and the pipeline of fresh talent is tapering off. Fewer than 20 percent of U.S. medical students are choosing to practice primary-care medicine, according to the Council on Graduate Medical Education, which advises and makes recommendations to the U.S. Department of Health and Human Services and Congress on physician workforce matters. Studies project a shortage of 44,000 to 46,000 primary-care doctors by 2025 unless action is taken to lure more medical students into the field and retain experienced primary-care doctors. And future demand for generalist physicians is expected to swell as the population ages."

The new health law does include "a number of programs to strengthen primary-care. But is it enough? In a 'Perspective' article published in the Annals of Internal Medicine in April, [internist John D.] Goodson argued that, to avert a primary-care crisis, medical schools must prioritize and support primary-care training, and policymakers have to do something about the nation's lopsided physician reimbursement system, which favors specialists. ... One potential solution is a team-based model of care called the 'medical home'" (Pallarito, 9/8).

Meanwhile,WBUR reports on Commonwealth Care Alliance, "a nonprofit that has reduced the hospitalization rate of its chronically ill, elderly patients by nearly half since the first enrollee came on board in 2004. … Commonwealth Care front-loads primary care and supports physicians in its network with a dedicated team of nurse practitioners, mental health and behavioral specialists, geriatric social workers and 'every medical and surgical specialist known to man.' The organization is essentially a full-service provider of medical care and social support. ... Patients can choose from 25 primary care sites around the state, and for the homebound, house calls are also part of the plan. For those who need to get to the hospital, Commonwealth Care contracts with 8 hospitals in the state, but will only use providers who agree to Medicare reimbursement rates" (Zimmerman, 9/9).

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