Newly insured to deepen primary care doctor gap - WFLA News Channel 8

Newly insured to deepen primary care doctor gap

Posted: Updated:

COLUMBUS, Ohio - Getting face time with the family doctor could soon become even harder.

A shortage of primary care physicians in some parts of the country is expected to worsen as millions of newly insured Americans gain coverage under the federal health care law next year. Doctors could face a backlog, and patients could find it difficult to get quick appointments.

Attempts to address the provider gap have taken on increased urgency ahead of the law's full implementation Jan. 1, but many of the potential solutions face a backlash from influential groups or will take years to bear fruit.

Lobbying groups representing doctors have questioned the safety of some of the proposed changes, argued they would encourage less collaboration among health professionals and suggested they could create a two-tiered health system offering unequal treatment.

RELATED LINK: A state-by-state breakdown of primary care doctors

Bills seeking to expand the scope of practice of dentists, dental therapists, optometrists, psychologists, nurse practitioners and others have been killed or watered down in numerous states. Other states have proposed expanding student loan reimbursements, but money for doing so is tight.

As fixes remain elusive, the shortfall of primary care physicians is expected to grow.

Nearly one in five Americans already lives in a region designated as having a shortage of primary care physicians, and the number of doctors entering the field isn't expected keep pace with demand. About a quarter million primary care doctors work in America now, and the Association of American Medical Colleges projects the shortage will reach almost 30,000 in two years and will grow to about 66,000 in little more than a decade. In some cases, nurses and physician assistants help fill in the gap.

The national shortfall can be attributed to a number of factors: The population has both aged and become more chronically ill, while doctors and clinicians have migrated to specialty fields such as dermatology or cardiology for higher pay and better hours.

The shortage is especially acute in impoverished inner cities and rural areas, where it already takes many months, years in some cases, to hire doctors, health professionals say.

"I'm thinking about putting our human resources manager on the street in one of those costumes with a 'We will hire you' sign," said Doni Miller, chief executive of the Neighborhood Health Association in Toledo, Ohio. One of her clinics has had a physician opening for two years.

In southern Illinois, the 5,500 residents of Gallatin County have no hospital, dentist or full-time doctor. Some pay $50 a year for an air ambulance service that can fly them to a hospital in emergencies. Women deliver babies at hospitals an hour away.

The lack of primary care is both a fact of life and a detriment to health, said retired teacher and community volunteer Kappy Scates of Shawneetown, whose doctor is 20 miles away in a neighboring county.

"People without insurance or a medical card put off going to the doctor," she said. "They try to take care of their kids first."

In some areas of rural Nevada, patients typically wait seven to 10 days to see a doctor.

"Many, many people are not taking new patients," said Kerry Ann Aguirre, director of business development at Northeastern Nevada Regional Hospital, a 45-bed facility in Elko, a town of about 18,500 that is a four-hour drive from Reno, the nearest sizable city.

Nevada is one of the states with the lowest rate per capita of active primary care physicians, along with Mississippi, Utah, Texas and Idaho, according to the Association of American Medical Colleges.

The problem will become more acute nationally when about 30 million uninsured people eventually gain coverage under the Affordable Care Act, which takes full effect next year.

"There's going to be lines for the newly insured, because many physicians and nurses who trained in primary care would rather practice in specialty roles," says Dr. David Goodman of the Dartmouth Institute for Health Policy and Clinical Practice.

Roughly half of those who will gain coverage under the Affordable Care Act are expected to go into Medicaid, the federal-state program for the poor and disabled. States can opt to expand Medicaid, and at least 24 and the District of Columbia plan to.

In Ohio, which is weighing the Medicaid expansion, about one in 10 residents already lives in an area underserved for primary care.

Mark Bridenbaugh runs rural health centers in six southeastern Ohio counties, including the only primary care provider in Vinton County. The six counties could see some of the state's largest enrollments of new Medicaid patients per capita under the expansion.

As he plans for potential vacancies and an influx of patients, Bridenbaugh tries to identify potential hires when they start their residencies — several years before they can work for him.

"It's not like we have people falling out of the sky, waiting to come work for us," he said.

State legislatures working to address the shortfall are finding that fixes are not easy.

Bills to expand the roles of nurse practitioners, optometrists and pharmacists have been met with pushback in California. Under the proposals, optometrists could check for high blood pressure and cholesterol while pharmacists could order diabetes testing. But critics, including physician associations, have said such changes would lead to inequalities in the health care system— one for people who have access to doctors and another for people who don't.

In New Mexico, a group representing dentists helped defeat a bill that would have allowed so-called dental therapists to practice medicine. And in Illinois, the state medical society succeeded in killing or gutting bills this year that would have given more medical decision-making authority to psychologists, dentists and advanced practice nurses.

Other states are experimenting with ways to fill the gap.

Texas has approved two public medical schools in the last three years to increase the supply of family doctors and other needed physicians. New York is devoting millions of dollars to programs aimed at putting more doctors in underserved areas. Florida allowed optometrists to prescribe oral medications — including pills — to treat eye diseases.

The federal health care law attempts to address the anticipated shortage by including incentives to bolster the primary care workforce and boost training opportunities for physicians' assistants and nurse practitioners. It offers financial assistance to support doctors in underserved areas and increases the level of Medicaid reimbursements for those practicing primary care.

Providers are recruiting young doctors as they gear up for the expansion.

Stephanie Place, 28, a primary care resident at Northwestern University's medical school in Chicago, received hundreds of emails and phone calls from recruiters and health clinics before she accepted a job this spring.

The heavy recruitment meant she had no trouble fulfilling her dream of staying in Chicago and working in an underserved area with a largely Hispanic population. She'll also be able to pay off $160,000 in student loans through a federal program aimed at encouraging doctors to work in areas with physician shortages.

Place said the federal law turned needed attention to primary care as a specialty among medical students.

"Medical students see it as a vibrant, evolving, critical area of health care," she said.

Even so, many experts say the gap between doctors and those gaining care under the health reforms in many parts of the country will not close quickly. Access to care could get worse for some people before it gets better, said Dr. Andrew Morris-Singer, president and co-founder of Primary Care Progress, a nonprofit in Cambridge, Mass.

"If you don't have a primary care provider," he said, "you should find one soon."

Don't miss out on the day's top Facebook conversations http://on.fb.me/18y81Cl

RELATED STORIES:

 

  • 8 On Your SideMore>>

  • Tax free back to school shopping is here

    Tax free back to school shopping is here

    Friday, August 1 2014 6:23 AM EDT2014-08-01 10:23:38 GMT
    It's almost time to head back to school and that means it's time to shop.
    It's almost time to head back to school and that means it's time to shop.
  • Tampa Bay woman feels ripped off, pays $61 for coins worth $1.50

    Tampa Bay woman feels ripped off, pays $61 for coins worth $1.50

    Thursday, July 31 2014 6:10 PM EDT2014-07-31 22:10:55 GMT
    Vickie McInnis responded to a newspaper ad promising a chance to buy old, rarely-seen coins.Vickie McInnis responded to a newspaper ad promising a chance to buy old, rarely-seen coins.
    Vickie McInnis responded to a newspaper ad promising a chance to buy old, rarely-seen coins that have been sitting in a bank vault for years.With shipping, she paid $61.43. But, here's what she received: a bag of about 100 pennies, worth at most: $1.50.
    Vickie McInnis responded to a newspaper ad promising a chance to buy old, rarely-seen coins that have been sitting in a bank vault for years.With shipping, she paid $61.43. But, here's what she received: a bag of about 100 pennies, worth at most: $1.50.
  • Tampa Bay Water begins filling Bill Young reservoir

    Tampa Bay Water begins filling Bill Young reservoir

    Thursday, July 31 2014 5:45 PM EDT2014-07-31 21:45:52 GMT
    Tampa Bay Water is celebrating a rebirth of sort for its beleaguered Bill Young reservoir. TBW is now diverting water from the Alafia river and filling the reservoir after a massive gutting and renovation project that cost in excess of $124 million dollars.
    Tampa Bay Water is celebrating a rebirth of sort for its beleaguered Bill Young reservoir. TBW is now diverting water from the Alafia river and filling the reservoir after a massive gutting and renovation project that cost in excess of $124 million dollars.
  • NewsMore>>

  • Pinellas school district asks Crist to pull TV ad

    Pinellas school district asks Crist to pull TV ad

    Friday, August 1 2014 5:32 AM EDT2014-08-01 09:32:42 GMT
    The Pinellas County school district is asking former Gov. Charlie Crist to pull a television ad filmed at an area high school.
    The Pinellas County school district is asking former Gov. Charlie Crist to pull a television ad filmed at an area high school.
  • Closing US 301 for repairs create headaches

    Closing US 301 for repairs create headaches

    Friday, August 1 2014 12:16 AM EDT2014-08-01 04:16:16 GMT
    It’s been a headache for many who travel U.S. Highway 301 in Riverview after the roadway was shut down. But FDOT expects the roadway to be back open about midnight Thursday.After a nearby construction crew damaged a 24-inch water line in the area, water poured out and created a hole, damaging the asphalt on U.S. 301.“It’s still every penny counts, I would say $30 to $50 possibly,” is how much the road closure cost Bee...
    It’s been a headache for many who travel U.S. Highway 301 in Riverview after the roadway was shut down. But FDOT expects the roadway to be back open about midnight Thursday.After a nearby construction crew damaged a 24-inch water line in the area, water poured out and created a hole, damaging the asphalt on U.S. 301.“It’s still every penny counts, I would say $30 to $50 possibly,” is how much the road closure cost Bee...
  • New "Fire challenge" video spurs warnings

    New "Fire challenge" video spurs warnings

    Thursday, July 31 2014 10:43 PM EDT2014-08-01 02:43:41 GMT
    Videos of a dangerous stunt are spreading all across social media. You can see examples on sites like Youtube and Facebook. It's called "The Fire Challenge" and involves young people dousing themselves with rubbing alcohol and lighting it up on their bodies. Burn victim and now, Tampa General Hospital volunteer, Joe Versaggi, knows all about the horrors of fire. He's undergone 30 surgeries after a fiery plane crash 8...
    Videos of a dangerous stunt are spreading all across social media. You can see examples on sites like Youtube and Facebook. It's called "The Fire Challenge" and involves young people dousing themselves with rubbing alcohol and lighting it up on their bodies. Burn victim and now, Tampa General Hospital volunteer, Joe Versaggi, knows all about the horrors of fire. He's undergone 30 surgeries after a fiery plane crash 8...
  • Sign up for WFLA News Channel 8 Email Alerts

    * denotes required fields






    Thank you for signing up! You will receive a confirmation email shortly.
  • Most Popular StoriesMost Popular StoriesMore>>

  • Giraffe dies after smashing head on low highway bridge

    Giraffe dies after smashing head on low highway bridge

    Thursday, July 31 2014 3:37 PM EDT2014-07-31 19:37:45 GMT
    A giraffe has been killed after smashing its head on a bridge while being transported dangerously on a highway in South Africa, wildlife officials said Thursday.
    A giraffe has been killed after smashing its head on a bridge while being transported dangerously on a highway in South Africa, wildlife officials said Thursday.
  • Screams, panic caught on video as shark charges at swimmers near beach

    Screams, panic caught on video as shark charges at swimmers near beach

    Wednesday, July 30 2014 5:48 PM EDT2014-07-30 21:48:04 GMT
    Facebook image from Dan FlynnFacebook image from Dan Flynn
    A Florida beach cleared out – with the exception of a woman and lifeguard who tried to save her – when a shark was spotted heading straight toward swimmers on Tuesday afternoon. The panic of the 10-foot shark and people screaming from the pier was caught on tape.
    A Florida beach cleared out – with the exception of a woman and lifeguard who tried to save her – when a shark was spotted heading straight toward swimmers on Tuesday afternoon. The panic of the 10-foot shark and people screaming from the pier was caught on tape.
  • Jury finds McTear guilty of 1st-degree murder in baby's death

    Jury finds McTear guilty of 1st-degree murder in baby's death

    Thursday, July 31 2014 5:40 PM EDT2014-07-31 21:40:19 GMT
    The jury has reached a verdict for Richard McTear in the death of his ex-girlfriend’s baby.
    The jury has reached a verdict for Richard McTear in the death of his ex-girlfriend’s baby.
Powered by WorldNow

200 South Parker Street, Tampa, FL 33606

Telephone: 813.228.8888
Fax: 813.225.2770
Email: news@wfla.com

Can’t find something?
Powered by WorldNow
All content © Copyright 2000 - 2014 Media General Communications Holdings, LLC. A Media General Company.