Patterico's Pontifications

9/13/2009

30-50M New Patients Means America Needs More Doctors

Filed under: Health Care — DRJ @ 2:16 pm



[Guest post by DRJ]

The AP has discovered that adding 30-50 million uninsured to the health care roles means America will need more doctors:

“Among the many hurdles facing President Barack Obama’s plan to revamp the nation’s health care system is a shortage of primary care physicians – those legions of overworked doctors who provide the front line of medical care for both the sick and those hoping to stay healthy.

As Massachusetts’ experience shows, extending health care to 50 million uninsured Americans will only further stress the system and could force many of those newly insured back into costly emergency rooms for routine care if they can’t find a primary care doctor, health care observers said.
***
To keep up with the demand for primary care doctors, the country will need to add another 40,000 to the existing 100,000 doctors over the next decade or face a soaring backlog, according to Dr. Ted Epperly, president of the Kansas-based American Academy of Family Physicians.

“It’s like giving everyone free bus passes, but there are only two buses,” he said.”

There are a range of ideas to solve the anticipated primary care shortage, including financial incentives that encourage medical students to enter the primary care field, regulations that equalize payments to primary care doctors and specialists like brain surgeons and cardiologists, and a team approach that allows nurse practitioners and health educators to provide basic care and counseling with primary care physicians. The latter option is already available in many parts of the country at Walmart, CVS Caremark, and Walgreens Pharmacies, as well as in many local clinics.

The linked article also quotes a medical student who plans to practice in pediatric primary care because “When I wrote on my medical school application that I wanted to help people, I really meant it.” I see this same attitude in law — an elitist attitude that you aren’t really helping people unless you’re helping the “right” people. Specialists help people, too. The neonatologist who saves the lives of sick and premature infants is helping the right people. So is the cardiologist who helps heart attack and stroke victims, and the brain surgeon who helps people with tumors and traumatic brain injuries. Preventive care won’t keep people from needing specialists — Ted Kennedy is a good example of that.

I want people to have preventive care and I want enough health care practitioners to provide it. To help make that happen, government should ease regulations and barriers to make it easier for nurse practitioners and physician’s assistants to work in the primary care field. But you don’t need sweeping health care reform to do that.

— DRJ

17 Responses to “30-50M New Patients Means America Needs More Doctors”

  1. The AP has discovered that adding 30-50 million uninsured to the health care roles means America will need more doctors

    Well, yeah.

    Paul (creator of "Staunch Brayer") (784fd8)

  2. The AP has discovered that adding 30-50 million people will cause waiting lists across the country for basic health care? Nah, they couldn’t have discovered that.

    John Hitchcock (3fd153)

  3. Most Western states have few barriers with NPs and PAs, the Texas based link says Texas is in the 5 strictest states, and the second link seems to indicate Florida is similar. Most PAs and many NPs are these days going into subspecialty care, where the work conditions (e.g. hours) and money is better. Sort of like with docs. Surprised?

    The shortage of primary care physicians is directly related to government action over the last 2 decades. I have seen numerous ‘fixes’ for primary care by the Feds, each worsens the problem by accidental design.

    Teflon Dad (287a17)

  4. Good point, Teflon Dad. There’s a new program in Texas that lets police officers draw blood in suspected DUI cases. As long as we have police officers, maybe we Texans won’t need those nurse practitioners and physicians’ assistants. (I’m kidding, but it may not be long until we all have a government-provided ‘home primary care kit’ and that might not be a bad thing.)

    DRJ (b0cdd4)

  5. I remember an article in the local paper many years ago about Ohio doctors emigrating. They were leaving Ohio in droves, headed southward and southwestward. The article pointed directly at TORT as the reason for the escape. The doctors could not afford the malpractice insurance and keep reasonably profitable, so they were going places that were far more reasonable.

    And, yes, I pointed this article out to my daughter, who was a young skull full of mush at the time. But that was like 10 years ago.

    John Hitchcock (3fd153)

  6. Well how many more? maybe 10-20,000 plus all the nurses and ancillaries….No problemo!
    The go to Sicko on this is the auteur of “Sicko”, who will gladly advise his buddy Fidel, who will happily deport all the “Health Professionals” America needs, and then some…
    That would be perfect; these guys would work for bed and board–bringing down costs—would speak Spanish–to treat those uninsured insured—and best of all believe that the word “malpractice” means “hoof it back to Cuba before the American police catch you”–hence making malpractice insurance unnecessary…
    C’mon guys! Give the shoeless doctore a chance!

    elixelx (bfcb6e)

  7. DRJ – I kinda like the idea of prescribing myself medication. If it were legal, that could be fun. I could start with a list of the shit I’ve never tried.

    daleyrocks (718861)

  8. Some of the Michael Jackson death stories have some good reference material I think.

    daleyrocks (718861)

  9. Don’t worry about it, friends. There are lots of people who once dreamed of being doctors, but they couldn’t hack the coursework. We’ll just lower the standards for medical school and start accepting those students who get a “B-” or “C” in Organic Chemistry and Human Physiology. If that doesn’t work, we can start taking the “C-” and “D+” students.

    JVW (d1215a)

  10. I’ll go with the home care kit like daleyrocks. I hope I get the kit with the Demerol.

    DRJ (b0cdd4)

  11. Heck JVW, you have to keep me apprised on this sort of thing. Half my job is getting the students who won’t work hard off the premed track.

    Eric Blair (0b61b2)

  12. EB: Stop grading on a curve. 😉

    I blew out a couple curve-graded tests in my early college years, and everyone hated me. Then someone else took my place and blew out the next couple tests… Sucks, when 4 tests in a row in a 6-week shortened summer course results in a 100 percent. 😛

    I remember my HS days of 90/80/70/60. I also remember my harder courses being 93/84/77/70. Oh, how the students hollered and wailed at the more aggressive standards! I loved it.

    John Hitchcock (3fd153)

  13. Nothing will attract new students to medical school like Tort Reform.
    With tort reform doctors will be back in control of medical treatment. It has been 40 years since the Malpractice Insurance Crisis, it is time for a solution.

    tyree (353f22)

  14. My regular medical care is with a FNP at a branch clinic in an even more depressed portion of our (20% unemployment) county. We lost the MD; the old boy network hindered her getting a gig as an OB-GYN at the county’s only hospital, and she moved on when her contract was up. Filling the gap is a FNP. Decent sort, and reasonably good. Our budget doesn’t permit really expensive care, but for my mild diabetes and hypertension, it works.

    The backup plan is the parent clinic in the big town, or if things get really bad, there’s the trip tothe Blue counties.

    FWIW, we’re a “hardship area” and there’s a subsidy for young doctors to take a position here for a while. Some of the old MDs should retire, but one of the worst looks like he’s planning on making a killing with Obamacare. Sigh.

    Red County Pete (bd8afa)

  15. “early college years” — I took 2 college courses between my JR and SR years of HS. And this is where the torture happened, pretty much.

    John Hitchcock (3fd153)

  16. “Preventive care won’t keep people from needing specialists — Ted Kennedy is a good example of that.”

    Well, I can think of one young woman who Ted Kennedy made sure never needed a specialist. (Or am I not supposed to mention that?)

    stuiec (dc3597)

  17. The barmaid or the try-athlete?

    John Hitchcock (3fd153)


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