When reviewing
the various new regulations concerning the Accountable Care Act and
particularly Accountable Care Organizations, it is clear that the Primary Care
Physician will be at the center of doctoring over the next several years.
While there already is a shortage of good primary doctors, the shortage is
about to get worse.
Here’s an article from Medscape Today:
ACA
Will Require 3% More Primary Care Physicians by 2025
Robert Lowes
Nov
12, 2012
The Affordable
Care Act (ACA), experts predict, will only deepen a
shortage of primary care physicians brought on by a growing — and
aging — population.
But to what
extent? A new study
in the Annals of Family Medicine offers a hard number. It will take an
extra 8000 primary care physicians in 2025 just to treat patients who obtain
insurance coverage under the law, according to lead author Stephen Petterson,
PhD, and coauthors.
In all, they
write, the nation will need 52,000 more primary care physicians in 2025 than it
has now, a figure resembling estimates in other recent studies. Before Congress
enacted the ACA in 2010, the Association of American Medical Colleges had forecast a
shortfall of 46,000 primary care physicians by 2025.
In the Annals
of Family Medicine study, sheer population growth accounts for 33,000 of
the 52,000 extra physicians needed in 2025, according to Dr. Petterson, the
research director of the Robert Graham Center for Policy Studies in Family
Medicine and Primary Care, affiliated with the American Academy of Family
Physicians, and colleagues. Another 10,000 physicians of the total reflect the
higher level of services used by baby boomers on the rolls of Medicare.
The ACA will
extend insurance to roughly 30 million more Americans through 2019. The 8000
primary care physicians required by this expansion represent a 3% increase of
the current workforce.
As a baseline for
their projection, Dr. Petterson and co authors used the 246,090 primary care
physicians who were engaged in direct patient care in 2010 as reported by the
American Medical Association. They whittled down that number to almost 209,000
after excluding physicians who were retired, working as hospitalists, or
working in emergency departments and urgent-care centers.
To calculate how many
primary care physicians will be needed in 2025, the authors estimated the
number of primary care office visits that would occur that year and divided it
by the current number of annual visits per physician, which is 2237. According
to this math, the United States ought to have almost 261,000 primary care
physicians 13 years from now, a 25% increase over 2010.
Coauthor Andrew
Bazemore, MD, MPH, director of the Robert Graham Center, called the workforce
growth required by just the ACA "a surprisingly small proportion" of
the total.
Fielding an
additional 52,000 primary care physicians in 2025 is a daunting task, Dr.
Bazemore said, given long-term preferences of most medical students for other
specialties. However, in the last 2 to 3 years "we've seen an uptick in
the number of medical student seniors choosing family medicine," he said.
That trend, along with proposals to increase the number of residency training
slots and earmark more of them for primary care, justifies "a little more
optimism," he added.
At the same time,
the healthcare system needs to not only grow the primary care workforce, but
also do a better job allocating clinicians to underserved areas.
"You need to
find a way to get the doctors to where they're needed," Dr. Bazemore said.
The authors have
disclosed no relevant financial relationships.
Ann Fam Med. 2012;10:503-509.