Will there be enough primary care physicians to meet the increased health care demand following passage of the PPACA?
General Reference (not clearly pro or con)
AARP stated in its June 10, 2010 fact sheet titled “Health Reform and the Workforce: Will There Be Enough Providers?” available at www.aarp.org:
“For several reasons, it is a challenge to assess whether the various provisions of the new law, together with initiatives independent of health reform, will be sufficient to ensure a large enough workforce, with the right kinds of providers distributed across the nation proportionate to need. First, little consensus exists on exactly how many providers is the “right” number to provide care, or the right mix of primary care physicians, nurse practitioners, nurses, physician assistants, and specialist physicians to meet changing care needs. Second, the law includes many provisions intended to change the way care is delivered; these provisions will likely alter the existing models of demand for services. Innovations such as the medical home, transitional care benefit, and incentives to reduce readmissions may change the mix of providers needed, while efforts to make care more efficient may reduce the number of providers required to deliver care. Finally, changes in overall population health make the future demand for health care uncertain.”
June 10, 2010
PRO (yes)
Pro
The American College of Physicians (ACP) stated the following in their Apr. 7, 2010 fact sheet “Ensuring an Adequate Supply of Primary Care Internists and Other Specialties Facing Shortages,” available at www.acponline.org:
“The recently enacted PPACA (H.R. 3590) includes numerous policies to train more primary care physicians and increase the supply of primary care physicians. These policies include: mandatory and increased discretionary funding for the National Health Service Corp (NHSC), reauthorization of Section 747 of Title VII, Training in Family Medicine, General Internal Medicine, General Pediatrics, and Physician Assistantship; creation of a Primary Care Training Extension Program and increased faculty scholarship loans, redistribution of 65% of the current unused Graduate Medical Education slots to primary care and general surgery and allowing residents to count their time spent in ambulatory settings to count towards their residency requirements, such as physician offices and community health centers; and the establishment of Teaching Health Centers, creating primary care residency programs in non-hospital settings.”
Apr. 7, 2010
Pro
The US Department of Health and Human Services stated the following in its “Fact Sheet: Creating Jobs and Increasing the Number of Primary Care Providers,” available at www.healthcare.gov (accessed Aug. 23, 2010):
“[T]he provisions of the Affordable Care Act will support the training, development, and placement of more than 16,000 new primary care providers over the next five years.
Some of the steps the Administration is taking to train new doctors… and strengthen the primary care workforce include…
– Creating additional primary care residency slots: $168 million for training more than 500 new primary care physicians by 2015;
– Supporting physician assistant training in primary care: $32 million for supporting the development of more than 600 new physician assistants, who practice medicine as members of a team with their supervising physician, and can be trained in a shorter period of time compared to physicians…
– Encouraging States to plan for and address health professional workforce needs: $5 million for States to plan and implement innovative strategies to expand their primary care workforce by 10 to 25 percent over ten years to meet increased demand for primary care services.”
Aug. 23, 2010
CON (no)
Con
The Association of American Medical Colleges (AAMC) stated the following in its June 2010 publication “The Impact of Health Care Reform on the Future Supply and Demand for Physicians Updated Projections Through 2025,” available at www.aamc.org:
“Questions have been raised as to whether there will be a sufficient supply of physicians and other health professionals to serve the nation, especially in light of concerns that the nation was facing potentially significant shortages even before health care reform…
[W]e project an overall shortage of 91,500 and 130,600 active patient care physicians in 2020 and 2025 respectively, and a primary care shortage of 45,400 and 65,800 physicians in 2020 and 2025…These revised estimates are consistent with earlier estimates: they indicate the health care system is likely to be facing severe pressure as demand rises more rapidly than the supply.”
June 2010
Con
John Geyman, MD, Professor Emeritus of Family Medicine at the University of Washington School of Medicine, stated the following in his July 29, 2010 article “Hijacked: Stolen Health Reform III: How Much Will Access to Care Be Expanded?,” available at www.pnhp.org:
“The U.S. is facing a shortage of 35,000 to 44,000 primary care physicians for adults by 2025. An increasing number of people with insurance coverage cannot find a primary care physician to take care of them, especially those on Medicare or Medicaid, due to low reimbursement in those programs…
Despite the hype we hear about ‘near-universal’ access just down the road with PPACA, the above leads us to believe that access to care will remain inadequate for much of the population.”
July 29, 2010
Con
Manny Alvarez, MD, Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine, stated the following in his Mar. 19, 2010 article “Here Comes the Health Care Bill… There Go the Doctors,” available at health.blogs.foxnews.com:
“[M]any physicians are really getting nervous because of the potential for disaster that this bill poses to the American health care system…
I truly believe that we don’t have enough health care practitioners to deal with the influx of patients that are going to be so quickly added to the insured pool of Americans. Why? Because I can hardly find a physician in the tri-state area that has an open panel available to take new Medicaid patients, and if you don’t believe me, try it yourself.
There is no ‘doctor fix’ in the language of this bill.”
Mar. 19, 2010
