What will 32 million uninsured Americans do after the Affordable Care Act helps them find health insurance? They'll use some health care, of course! According to the Congressional Budget Office, an individual's demand for health services goes up by about 40 percent once he or she receives coverage.
That'll mean a lot of work for America's primary care physicians--family practitioners and internal medicine docs, mostly. Except that U.S. medical schools aren't producing enough primary care docs to handle the current workload, let alone provide care for 32 million new patients.
Med school grads have been opting for specialties where they can make more money, do less paperwork, have more predictable hours: Let's replace a couple of knees this morning and hit the links!
When Massachusetts mandated health coverage for everyone, the average wait time for a new patient to see an internist spiked to 52 days. The good news is you're insured. The bad news is Dr. Smith can't see you until next summer.
The feds are offering scholarships, loan forgiveness and tax breaks to primary care doctors and nurses working in underserved areas. But will there be enough time to staff up before those 32 million people start looking for docs?
"That's why the mandate for individual coverage comes in 2014, so there's time for a ramp-up to begin," says Jerry Friedman, associate vice president in the Office of Health Sciences at Ohio State University.
But, umm, doesn't medical school usually take four years, not to mention internships and residencies? "Three years is not a lot of time to get new doctors to meet the demand," acknowledges Friedman.
One solution may be staffing down instead of up. Tiffany Himmelreich, manager of media and public relations for the Ohio Hospital Association, says health-care providers are looking at "new and creative ways to reform the delivery system," including everything from drugstore "minute clinics" run by nurse practitioners to "Grand-Aides," trained community health workers who can take your pulse, take your temperature and ... listen.
"Eighty percent of the people who go out seeking help would be aided by a grandmother's wisdom," says Friedman. "We probably have doctors doing a lot of things that could be handled by other people."