Physician Shortage: Fact or Fiction? A Look Into the Rumors of a Shortage
– By Richard A. Longo, RN, FACHE, FACMPE
So, you need to see a primary care doctor. You’ve had a nagging lump in your neck that is causing concern and you figure it’s time to get it checked. After dialing your family physician, you’re told that you can schedule an appointment, but you’ll have to wait for almost 2 months before the doctor has time to see you.
This is a scary scenario, but unfortunately this is what some patients in Massachusetts are facing today. In 2006, the state legislature passed a healthcare reform that bears similarities to the Obama administration’s recent bill. This healthcare reform, combined with an already stressed healthcare system, is making it a little bit tougher for Massachusetts residents to access healthcare.
Does the healthcare situation in Massachusetts serve as a warning for the rest of the country?
Growing Shortage Concerns
For years, the healthcare industry has been plagued with growing concerns over a potential physician shortage. As a nation, we have been blessed with ready access to healthcare. Sure, you still hear the stories of people that have to wait in emergency rooms for hours with a gaping wound before they are seen by a nurse or physician. Urgent care is unpredictable, and thus, there is no way to gauge how long one would have to wait before gaining entrance to a curtained bed to be examined. It is also not uncommon having to wait for 30 minutes to an hour for a primary care doctor to glance down your throat to confirm that, yes, you do in fact have a strep infection and hand you a prescription for an antibiotic. The chronic condition of waiting for medical care is infamous, and there does not appear to be any hope of this lessening in the years to come; in fact, it is only looking to get worse.
Several studies by different organizations have reached forecast assumptions about what the shortage could look like in terms of patient to doctor ratios. The lowest projection from the Department of Health and Human Services shows a shortage of over 65,000 by 2020, while other projections have the shortage upwards toward the 200,000 mark.
Impact of Healthcare Reform
President Obama’s signature sealed the Patient Protection and Affordable Care Act (hereafter referred to as the healthcare reform act). With that flick of the pen, the President introduced an additional 30 million patients into the healthcare system. This increase of just 4% has the potential to stress an already ailing system to the max. Any person who has needed medical care in their life time knows the importance of having access to care. But the question remains if our hospitals and primary care doctors’ offices are ready for the influx of patients.
Other Contributing Factors
Aside from the healthcare reform act, there are other major factors contributing to the impending physician shortage. The “baby boomer” generation is quickly reaching retirement age, and with it, many physicians will be hanging up their stethoscopes in exchange for post-retirement vacations and other leisurely activities. According to the Association of American Medical Colleges, one-third of the active physician population is over the age of 55. The Pennsylvania Medical Society reported that in 2006, fewer than 8 percent of physicians in the state were under the age of 35.
According to the U.S. Census Bureau, the trend from 1990 to 2000 in population growth showed an increase of 13.2 percent, representing 32.7 million people. Data from the 2010 census has yet to be released; however, there does seem to be a continued rise in the nation’s population growth rate.
The Association of American Medical Colleges has recommended that admissions into medical school increase by 30 percent in an attempt to close the gap. However, even if the rate of admissions does go up, many of these medical students will choose to go into a specialty, leaving primary and urgent care doctors still in short supply.
It is likely that many patients will start being seen by nurse practitioners and physician assistants, as opposed to a doctor.
What You Can Do
It is nearly impossible to tell if the predictions of the physician shortage will come into full bloom, and if they do, whether it will be as harsh as expected. Now, the question becomes, if a shortage rears its ugly head in the next few years, what, if anything, can you do to make sure that your employees are getting the care they need?
The answer is that, yes, you can be instrumental in ensuring that you and your employees stay covered.
Review Your PPO Network: Take another look at your PPO network to make sure that there is strong coverage for primary care physicians and urgent care facilities, such as hospitals. Make sure that this includes facilities not only close to your office locations, but also within close proximity to your employees’ home locations. If there is significant holes in your network, contact your PPO network to find out if they can negotiate contracts with facilities within the range that you want them. Your network should be willing to attempt to contract with out-of-network providers to expand your in-network options.
Find a Primary Care Physician: Encourage your employees to find a primary care physician as soon as possible if they do not currently have one. New employees, in particular, may not have a family doctor if they relocated for their job or if their former doctor is no longer in-network. Many physicians will stop accepting new patients if their patient load becomes too great. When “shopping” for a new primary care physician, it is important to ask about their policy for same day appointments in case of sickness or injury. This will help lessen the need to go to the emergency room for urgent care, where a longer wait is likely.
Employees on Retail Health Clinics: The consumer world of healthcare has arrived, and it can be a viable option when urgent care is needed quickly. Even though retail clinics have been around for 10 years, many people are still relatively uneducated about their existence. Instead of visiting a physician office or the emergency room, your employees can pull up to a Walgreens, MinuteClinic, or other retail clinic to be seen by a medical professional, who is typically a nurse practitioner or physician assistant.
Retail health clinics are an excellent alternative to traditional office or emergency room visits. Not only are they convenient, but they tend to be less expensive as well. The only drawback to retail clinics is that they only treat certain minor conditions. Your network should include retail clinics, and if it doesn’t, you will want to speak to your PPO network about including them to the network. Not every state has retail clinics, but they are becoming more popular. Urban areas are more likely to have multiple retail clinics than rural parts of the country.
While not much can be done by the general populations in terms of the broader medical care issues, every precaution and strategy should be taken to ensure that your employees are able to receive care in an effective and efficient manner.
About the Author
Richard A. Longo, RN, FACHE, FACMPE, possesses extensive and varied experience in healthcare management and strategy development gained through over 25 years in the healthcare industry. He is currently the Senior Vice President of Network Management for Devon Health Services, Inc., one of the largest regional PPOs in the Northeast. He currently holds an adjunct faculty position in the Doctor of Nursing Practice program at Waynesburg University. He is also duly “Fellowed” in both the American College of Health Care Executives (ACHE) and the American College of Medical Practice Executives (ACMPE) and only one of a few individuals nationally who have attained this dual status. For more information on Devon Health, please visit devonhealth.com. Richard can be reached at rlongo@devonhealth.com.
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