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Health law impacts primary care doc shortage

Posted on 12/7/14 at 9:42 pm
Posted by wickowick
Head of Island
Member since Dec 2006
45793 posts
Posted on 12/7/14 at 9:42 pm
LINK

quote:

The Papas were among the 6.7 million people who gained insurance through the Affordable Care Act last year, flooding a primary care system that is struggling to keep up with demand.

A survey this year by The Physicians Foundation found that 81 percent of doctors describe themselves as either over-extended or at full capacity, and 44 percent said they planned to cut back on the number of patients they see, retire, work part-time or close their practice to new patients.

At the same time, insurance companies have routinely limited the number of doctors and providers on their plans as a way to cut costs. The result has further restricted some patients' ability to get appointments quickly.


quote:

One purpose of the new health law was connecting patients, many of whom never had insurance before, with primary care doctors to prevent them from landing in the emergency room when they are sicker and their care is more expensive. Yet nearly 1 in 5 Americans lives in a region designated as having a shortage of primary care physicians, and the number of doctors entering the field isn't expected to keep pace with demand.

The Association of American Medical Colleges projects the shortage will grow to about 66,000 in little more than a decade as fewer residency slots are available and as more medical students choose higher-paying specialty areas.


Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 12/7/14 at 9:55 pm to
quote:

One purpose of the new health law was connecting patients, many of whom never had insurance before, with primary care doctors

Anybody who actually believed ACA would do this is an imbecile.
Posted by Aubie Spr96
lolwut?
Member since Dec 2009
41059 posts
Posted on 12/7/14 at 10:00 pm to
Is this why they are pushing the nurse practitioner thing?
Posted by Cosmo
glassman's guest house
Member since Oct 2003
120165 posts
Posted on 12/7/14 at 10:01 pm to
thanks obama
Posted by wickowick
Head of Island
Member since Dec 2006
45793 posts
Posted on 12/7/14 at 10:06 pm to
How many new doctors graduate every year? How many retire? I bet it is not possible to greatly increase numbers in the next 10 years...
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 12/7/14 at 10:06 pm to
quote:

Is this why they are pushing the nurse practitioner thing?

And PAs. They will start playing a bigger and bigger role in PC.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 12/7/14 at 10:10 pm to
quote:

How many new doctors graduate every year? How many retire? I bet it is not possible to greatly increase numbers in the next 10 years...

Its not just that, but the fields graduates are choosing to enter. As the article noted, specialties like emergency med, ortho, derm, etc are become increasingly popular often times at the expense of PC fields. Couple this with decrease in residency funding and lower reimbursement, and you wonder why there is a PC shortage.
Posted by Aubie Spr96
lolwut?
Member since Dec 2009
41059 posts
Posted on 12/7/14 at 10:15 pm to
Shame they won't let the market figure this shite out.
Posted by matthew25
Member since Jun 2012
9425 posts
Posted on 12/7/14 at 10:45 pm to
Ole Miss is enlarging the med school to pump out more doctors in response to ACA.

And a lot of skyping to the Miss. Delta, an area that has never had doctors willing to live there. Entire floor will be devoted to 80 inch screens to talk to patients.
Posted by mahdragonz
Member since Jun 2013
6931 posts
Posted on 12/7/14 at 11:01 pm to
So what? It's a short term problem?

Think logically about it. Huge numbers of people didn't have insurance to see a doctor before. Now many have insurance for the first time so the numbers will obviously jump. Over a few years the levels will even out.

Also, doctors have had to deal with more severe cases of disease bc people didn't do preventative care. Now with more access to doctors - patients will be treated earlier and managed better (think cancer or diabetes)

More doctors may be interested in general med as time goes on.
This post was edited on 12/7/14 at 11:03 pm
Posted by pleading the fifth
Member since Feb 2006
3886 posts
Posted on 12/7/14 at 11:09 pm to
What potential medical student wants to go to 4 years of med school after 4 years of college then 3 years of residency to barely make $100k a year? Medicare/Medicaid reimbursement is terrible and that's basically the only patients they will get.
Posted by HailHailtoMichigan!
Mission Viejo, CA
Member since Mar 2012
69246 posts
Posted on 12/7/14 at 11:10 pm to
This will be a non-issue in a few years, as basic economics tells us that an increase in the demand for a good will lead to an increase in quantity supplied.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 12/7/14 at 11:13 pm to
quote:

Over a few years the levels will even out.

What will level out? You understand this isn't like other normal markets. The amount of new doctors is limited by residency training spots, and that number is going in the wrong direction.
quote:

Also, doctors have had to deal with more severe cases of disease bc people didn't do preventative care. Now with more access to doctors - patients will be treated earlier and managed better (think cancer or diabetes)

This is very, very wishful thinking. Well, when the disease gets severe, they are probably getting specialty care by that point and aren't being managed solely by a PCP.
quote:

More doctors may be interested in general med as time goes on.

They may, but if things don't change I doubt it. Why would they be? You get paid less than pretty much any other field in medicine, you deal with more red tape/BS than other specialties, and in order for your practice to just break even, you have to schedule a ton of patients in not so much time.

Or you can go into EM and just have to do 18 12 hour shifts in a month and get paid more money.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 12/7/14 at 11:14 pm to
quote:

This will be a non-issue in a few years, as basic economics tells us that an increase in the demand for a good will lead to an increase in quantity supplied.

Yea, this would apply if health care were a free market (or anything close to it). That is not the case.
Posted by HailHailtoMichigan!
Mission Viejo, CA
Member since Mar 2012
69246 posts
Posted on 12/7/14 at 11:15 pm to
quote:

Yea, this would apply if health care were a free market (or anything close to it). That is not the case.
A massive increase in people seeking care will lead to a massive increase in people seeking to become doctors.

It really is that simple.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 12/7/14 at 11:18 pm to
quote:

A massive increase in people seeking care will lead to a massive increase in people seeking to become doctors.


Yes, seeking is the key word there. In our current system, that will just translate to more med school rejection letters being sent out or "unfortunately you did not match into a residency program" email going out. There is a ton of red tape that must be removed first in order for your "simple" statement to be a true statement.
Posted by the808bass
The Lou
Member since Oct 2012
111496 posts
Posted on 12/8/14 at 12:20 am to
quote:

How many new doctors graduate every year? How many retire? I bet it is not possible to greatly increase numbers in the next 10 years...


Bring on the foreign docs!!!!
Hooray!!!!
Posted by Roger Klarvin
DFW
Member since Nov 2012
46505 posts
Posted on 12/8/14 at 12:43 am to
To be fair, getting into residency isn't really a problem for American grads...yet. The vast majority of medical school graduates who do not match are foreign and Caribbean students. And most of the American grads who fail to match only because they applied too ambitiously or to too few programs.
Posted by Taxing Authority
Houston
Member since Feb 2010
57090 posts
Posted on 12/8/14 at 12:58 am to
quote:

Also, doctors have had to deal with more severe cases of disease bc people didn't do preventative care. Now with more access to doctors - patients will be treated earlier and managed better (think cancer or diabetes)
Fail...

LINK /
Posted by Taxing Authority
Houston
Member since Feb 2010
57090 posts
Posted on 12/8/14 at 12:59 am to
quote:

A massive increase in people seeking care will lead to a massive increase in people seeking to become doctors.

It really is that simple.
Nope. Just about everyone would like gold bars. But there isn't much of an increase in gold bar supply as a result.
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