An acute shortage of doctors

Opinion: July 13, 2011 at 12:00a.m.

By Annette Fuentes

McClatchy-Tribune

The United States faces a shortage of doctors that will only get more acute if we don’t respond to it now.

The doctor shortage varies by medical specialty and region, with primary care and family doctors — who provide cradle-to-grave care — being most in demand. Many rural and urban areas with high numbers of low-income residents are especially underserved by health care professionals.

When President Obama’s health reform law fully kicks in by 2014 and an estimated 32 million people are newly insured and seek medical care, wait times to see a doctor will probably get longer than they are already.

The Association of American Medical Colleges estimates that in the next 10 years, there will be 45,000 too few primary care doctors and 46,000 too few medical specialists (such as urologists and oncologists). By 2025, the total U.S. physician supply could be 130,000 below the demand of our population.

Doctor shortages could be especially bad for millions who will become eligible for Medicaid, the public insurance program for the poor. In many states, few doctors are willing to take Medicaid patients because the reimbursement rates are too low. For example, a survey of California physicians found that 90 percent were willing to take new patients, but just 57 percent willing to take new Medicaid patients. Nationally, one survey found just 53 percent of physicians willing to take Medicaid patients.

The aging of Americans is another factor that will contribute to the physician supply problem. Older people have greater health care needs and place a greater demand on the limited pool of doctors.

Doctors are growing old, too, with about a third of them set to reach retirement age in the next 10 years.

Replenishing the physician pool takes time, though.

Long process

Educating new doctors is a decade-long process, from medical school to internships and or residency programs. Congress foolishly placed a cap on funding for residency programs, provided by Medicare, back in 1997, and the number of residency slots has not increased since then.

Lifting that cap and pumping more resources into graduate medical education is one obvious and necessary fix.

Another needed reform is to boost reimbursement rates for physicians who care for Medicaid patients.

The Patient Protection and Affordable Care Act promised to deliver more health care to more people, but that promise will be empty if there aren’t enough doctors available and willing to deliver on it for the millions of newly insured Americans.

Annette Fuentes is the author of the just-published book “Lockdown High: When the Schoolhouse Becomes a Jailhouse.” She wrote this for Progressive Media Project, a source of liberal commentary on domestic and international issues; it is affiliated with The Progressive magazine. Distributed by McClatchy-Tribune Information Services.