Primary Care Provider Supply Analysis

The aim of the ACA is to provide affordable health care to all Americans, but it still leaves some issues unaddressed that will impact the access to health care. Covino (n.d.), “Though the intentions of the legislation are good, the Affordable Care Act does little to improve the actual health care delivery system” (para.1, page 2). According to the American Medical Association, we are facing an increasing Physician shortage. As of 2010 we faced a shortfall of 13,700 physicians, the estimate is that number will increase to 62,900 by 2015, 91,500 by 2020, and 130,600 by 2025 (Krupa, n.d.), with primary care taking the largest impact. Health Care coverage will be of no benefit if there are no doctors to treat the patients. An example of this occurred in 2002 when Thailand’s’ “30 Bhat Scheme” added (CNN n.d.) “14 million people to the country’s health care system, resulting in long waits and subpar service” (Your health is covered, but who is going to treat you?) Several factors contribute to the physician shortage. Many physicians are reaching the age of retirement, the Association of American Medical Colleges estimates nearly 15 million physicians will be eligible for Medicare in the coming years (CNN n.d.). The increasing cost of malpractice insurance also deters many from pursuing a career in medicine, and is forcing some doctors to retire. Also contributing to the physician shortage is a lack of spots in residency programs. “In 2011, more than 7,000 were left

According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.

The new federal health-care law has raised the stakes for hospitals and schools already struggling to train more doctors. Evidence suggests there won’t be enough number of doctors to treat the newly insured millions under the ACA. At current graduation and training rates, America faces a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The greatest demand will be for primary-care physicians. Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more with longer wait times under the new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER

Like what was stated previously, the cost of having Nurse Practitioners in place of doctors is lower. This is because their salaries are much less and the cost structure is lower. Evidence of this can be seen with Medicare and Medicaid. These government sponsored programs will pay for 85% of these services in comparison with doctors. This is important, because it is showing how the lower cost structure is one reason why Nurse Practitioners are playing a major role inside a health care environment. (Pickert, 2009)

Currently, there is still a large shortage of primary care practitioners in the United States. The margin between available providers and those in need continues to grow. Many people without proper access to care have to delay seeking help for what ails them ("Health Wanted," 2012). Glicken & Miller (2013) state that approximately 16,000 primary care providers would be necessary to meet the existing demand. Rural communities would represent the area of greatest need followed closely by low-income urban areas. The number of underserved individuals is estimated to have reached fifty-seven million. This demand will only increase, as 52,000 primary care providers are expected to be needed by the year 2025 (Glicken & Miller, 2013, p.1883-1889).

The purpose of this paper is to address the issue of the physician shortage in Unite State of America. This is more exactly delineate as a gap between the population’s demand for primary care services and the capacity of primary care, as currently delivered, respond to the demand. According to Nile (2015), physician is person trained and licensed to practice medicine or an individual with a Doctor degree in medicine. Physicians play a central role in health care delivery. Although now, physicians are sharing patient care responsibility with a team of Physician assistant (PA) and Nurse Practitioner (NP), especially with the Patient Protection and Affordable Care Act implementations. The PA and NP are alternative to medical doctor or physician

Primary care access is a growing concern for all Americans and the reason behind this concern is an imbalance between demand for care and capacity to provide care. Demand is growing as the population expands, ages, and faces chronic illnesses and the capacity is shrinking as the ration of primary care clinicians to population drops (Ghorob & Bodenheimer, 2012). A primary goal of the Affordable Care Act (ACA) was to improve access to quality health care for uninsured Americans, largely through public and private insurance expansions (Polsky et al, 2015). At the same time, the architects of the law recognized the need to increase the availability of primary care providers to meet the increased demand for health care (Pg. 538, 2015).

The Obamacare/ACA, might have helped numerous of individuals in acquiring health care, but the health professionals are facing a shortage of reimbursement difference for their services. As a result, Hospitals and healthcare providers were force to layoff personal and come up with innovative solutions. This point is proven by the renowned author, Amy Anderson by stating as follows: “The American health care framework has had shortages of personnel for quite some time and would not be prepared to give the adequate service to this amount of patients in need of medical attention. Training new professional health services personnel could take years. There is a shortage of graduates from medical and nursing schools. Doctors, nurses and health professional are sharing responsibilities prospective patients will face a longer wait time”. (Anderson, 2014)

Americans will have insurance coverage. The US has an unequal distribution of the primary care, thus; the rural areas have been left with only few physicians. Many physicians prefer practicing in urban areas because of the lucrative advantage, better technology or demographic preference. Many sources including Green et al, of Anita Phigpen Perry School of nursing confirms that the reason for the shortage of physicians in the rural areas is due to the tendency of people in the rural areas being poorer, sicker and older . This segment of people tends to be uninsured, and physicians are attracted to urban and suburb areas where revenues are. Today with the ACA policies, people in the underserved area have better access to physicians, although the shortage persists. The US Department of Health and Human Services, states that to help strengthen access to the primary care workforce, the Affordable Care Act invests in health work force training, including: a $ 1.5 billion investment in National Health Service Corps Scholarship and loan repayment programs and $ 230 million over five years to primarily train medical residents in community-bases. However, do we have enough experts?

“A Council on Graduate Medical Education document anticipated that there had, “been 242,500 PCPs within the United States in 2010, and nearly 25% (55,000) of them aged ≥56 years. The common reimbursement for PCPs is approximately only 55% that of other scientific specialties, main to a cumulative lifetime internet income gap of about $ 3.5 million per primary care physician” (Collins, 2012). This makes being a primary care physician less desirable since the incentive is so low. A similar associated issue is the very low percent of medical institution students who are choosing to become primary care physicians. Another issue is that about 59 million Americans live in regions with health professional shortages. Shortages in a number of other primary care healthcare specialists exist, especially with nurses. “In 2014, US schools turned away almost 70,000 qualified nursing applicants because they didn’t have the capacity for them. In fact, almost two-thirds of surveyed nursing schools cited faculty shortages as the reason for not accepting all qualified applicants into nursing baccalaureate programs” (Erickson, 2016). This greatly contributes to the shortage of nurses if they cannot receive proper education and training to join the workforce. Many healthcare service professionals shortages are in regions within

The new healthcare reform act recently passed will be fully implemented by 2014. Every person living legally in the United States will be guaranteed, under the Patient Protection and Affordable Care Act, (PPACA), healthcare insurance. Across the United States, primary care doctors are already preparing for the full impact this will have on their practices. In keeping with the promise made by President Obama, physicians are already planning to increase their hours while trying to maintain patient care.

Today, the United States is facing a shortage of about 16,000 primary care physicians and this number will continue to grow by 2025 (Amirault, 2014). Primary care physicians (PCPs) are the doctors who focus on overall health and offer the treatments and preventive screenings that save lives. A physician shortage is a situation in which there are not enough providers to treat all patients in need of medical care. The Association of American Medical Colleges (AAMC) has long pointed out that the shortage of primary care physicians will be a major setback for the American healthcare system advancing (Amirault, 2014). The shortage of primary care providers presents

The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination.

According to the U.S. Census, the United States population is projected to reach 400 million by 2050 with an expected growth of approximately 87 million for individuals over the age of 65. This growth rate for the elderly population is projected to impact policy, health care programs, and health care providers (Ortman, Velkoff & Hogan, 2014). As the population increases and ages, the need for advance care planning will also increase, therefore changes must be made within the healthcare system that will accommodate services and policy of reimbursement plans must be established to cover necessary care.

Although Medicare-for-all seems like a viable option for our country’s ongoing battle with healthcare access and coverage issues, there are several tradeoffs that must be considered. From a healthcare provider’s perspective, universal coverage will significantly increase the volume of services demanded at any given point in time. If enacted, Medicare-for-all will permit millions of previously uninsured Americans to obtain coverage in a relatively short period of time. In turn, healthcare providers, who are already struggling to meet the increased demand of expanded coverage under the Affordable Care Act, will face an even greater influx of patients with the same number of resources. Each day, physicians will be required to see more patients than before, take on a larger care burden, and as a result, be faced with provider burnout due to increased mental and physical strain (Christopher, 2017). The Agency for Healthcare Research and Quality maintains that there is a consistent relationship between overexerted, fatigued physicians and lower levels of care quality and patient safety (“Physician Burnout,” 2017).