The United States will need about 52,000 new primary-care doctors as the population grows and ages, according to a new study by Annals of Family Medicine. While the US is already in a shortage, it is increasingly exacerbated by 2 main reasons–medical school students choosing more specialized paths and the Affordable Care Act. In this article, we will dive deeper into these 2 problems and the possible solutions available. Find out how primary care physician shortage will affect Healthcare.
Medical Students Choosing Specialized Paths
The problem does not appear to be one of too few doctors in general; in fact, in 2011 more than 17,000 new doctors emerged from the country’s medical schools, according to the Association of American Medical Colleges (AAMC). Too few of these doctors, however, choose primary care as a career.
Of those 17,000 third-year residents, only 21.5 percent were planning on a career as an internal medicine doctor, a drop of nearly 27 percent since 2007. Within the two different tracks available within an internal medicine residency program, about 40 percent of students in a primary-care residency program and about 20 percent of those in a categorical residency program.
Many believe the shift has been caused by the current status of primary care physicians within the medical community. Comparatively, primary care specialties are not as well paid, well treated or respected as compared to subspecialists. Some primary-care residents may choose specialty careers because they think they’re more lucrative. Hot career choices are cardiology, gastroenterology, and radiology. In addition, the primary care community is projected to experience significant changes and enormous growth over the next few years.
The Affordable Care Act
Compounding the likely shortage is health care reform under the Affordable Care Act, a change that will expand health insurance coverage to an additional 38 million Americans. This new plan is expected to flood the system with new patients in the coming years. The medical field is concerned that over the next few years, patients will have increasingly difficult access to the primary care physician, leading saturated offices with to longer wait times and denial of new patients.
Solving the Primary Care Physician Shortage
There are several ways to entice medical students to choose primary-care careers. This may involve getting rid of some of the non-care-related demands of the job, such as paperwork and the routine time spent haggling with insurers about reimbursement. If not ridding the job of these duties, then reimbursement for them. The system pays physicians for direct care, however they spend 60 percent of their time doing activities that are not currently reimbursed – like following up with patients, coordinating with other doctors and other administrative tasks.
One suggestion to help alleviate the weight of a potential patient flood is that non-physician medical professionals, such as nurse practitioners and physician assistants, can pick up the slack. This is debated among medical professionals and patients alike, as doctors and nurses educations are fundamentally different.
Other incentives could include debt forgiveness for primary care routes, as many medical students have significant debt, or placing limits on hours and commitment, as many medical students are choosing careers with set boundaries on their time, such as the hospitalist track.
A fundamental change could be brought about through restructuring how we think about patient care. Some experts believe patient-centered homes, where everyone works on a team in an effort to increase the number of patients per provider, could help reduce stress and increase the quality of patient care.