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Doctor Shortage Becoming Crisis Under Affordable Care Exchange
By: Nick Tate





If it feels like you’re spending more time in the waiting room of your doctor’s office these days, it’s not your imagination. Family doctors are busier than ever. For many people, it is becoming difficult to even find a doctor, say experts who blame Obamacare for accelerating the nation’s doctor shortage.

According to a new analysis by the Association of American Medical Colleges:
•    The United States now is now facing a dire shortage of some 9,000 primary care doctors — including general internists, family doctors, geriatricians, and pediatricians.
•    Over the next 15 years, those shortages will worsen dramatically — particularly in rural areas, inner cities, and other areas where fewer doctors practice — with the deficit projected to hit 63,000 by 2015 and be double that number by 2025.
•    Shortfalls are also predicted for a range of medical specialties, including allergy specialists, cardiologists, psychiatrists, general surgeons, and emergency doctors.
•    Medical schools are not likely to churn out enough doctors to head off the crisis because fewer medical students are interested in primary care as a career because of lower pay and more insurance red tape.

What’s driving the trend, health experts say, is the nation’s growing population of older Americans using more healthcare resources. At the same time, as many as 1 in 3 practicing physicians are nearing retirement age.

What’s more, the addition of some 30 million patients newly covered by insurance — as mandated by the Patient Protection and Affordable Care Act (“Obamacare”) — will strain the low supply of U.S. doctors even further.

“We have record numbers of baby boomers entering the Medicare program, and once you hit 65 and older your healthcare needs escalate," says Christiane Mitchell, AAMC’s director of federal affairs. "You also need much more specialty care and intensive care than other groups.”

Many of the newly insured Obamacare patients have not received healthcare in many years, and they will require extensive care for previously untreated conditions, says Mitchell, adding “just the sheer number of them will put more strain on the system.”

Mitchell says the bottom line for consumers is: “Just because you’re going to have a health insurance card doesn’t necessarily mean you’re going to have access to care.”

Healthcare experts say one solution is to encourage medical schools to train more young doctors and push them into residency programs that train for primary care. But as sensible as that option seems, most specialists say it won’t be enough. For one thing, not enough medical students are enrolled to alleviate the shortages. For another, nearly 80 percent of today’s med students are planning careers as medical specialists and not primary care doctors.

A new study published last month in The Journal of the American Medical Association found that even with such financial incentives, the vast majority of medical students still plan to become specialists. Among the reasons cited: Family doctors have longer hours, lower pay, higher patient loads, and greater insurance paperwork demands.

Mayo Clinic Professor Colin P. West, M.D., said the findings are particularly troubling because general internists are seen as keys to the healthcare reform efforts, with many specialists viewing primary care doctors as the “quarterbacks” who coordinate patients' care.

Primary physicians “are expected to play an increasingly critical role in health care provision as the population ages, the burden of chronic disease grows, and healthcare reform targets coverage of tens of millions of currently uninsured patients,” Dr. West noted. But he added: “Current medical training models in the United States are unlikely to produce sufficient numbers of general internists and primary care physicians.”

The Association of American Medical Colleges issued a report on doctor shortage which found that more than three dozen major state and national studies have raised alarms about physician deficits over the past decade, but there has been little planning to head off the crisis.