Affordable Care Act Could Magnify Shortage of Doctors

Posted at: 10/21/2013 6:20 PM
Updated at: 10/22/2013 7:14 PM
By: Naomi Pescovitz

It is a parent's dream: watching a son or daughter grow up to become a doctor. With the Affordable Care Act about to kick in, we will need new doctors more than ever.

As millions more Americans gain insurance and the need for doctors grows, will there be enough physicians in the system?

As of right now, the answer is no.

According to the Metro Minnesota Council on Graduate Medical Education, the nation is facing an expected shortage of 90,000 doctors in the next ten years. Minnesota's shortage could reach 2,000 doctors.

The main concern is primary care, where the nation is expected to run about 45,000 doctors short in the next decade.

"The challenge of the Affordable Care Act is that it promises greater access to care for a much larger proportion of the population. And there have to be physicians to deliver that care," said Dr. John Andrews, Associate Dean for Graduate Medical Education at the University of Minnesota Medical School.

"Approximately 25 percent of our graduates nationally go into primary care specialties, internal medicine, pediatrics, family medicine," said Dr. Meghan Walsh, Chief Education Officer at Hennepin County Medical Center.

"Really at this rate with only 25 percent of the graduates going into primary care and 4 percent going to rural communities, we're all going to be challenged with a physician deficit," Walsh said.

KSTP sat down with a group of fourth year medical students bucking the trend. While their peers are going into lucrative fields like plastic surgery, we spoke to the doctors that will treat your every day aches and pains.

"For me, picking pediatrics was as simple as who I wanted to see on the other side of the door when I walked into a clinic room," said U of M medical student Yael Smiley.

KSTP asked the students what the shortage of primary care doctors will mean for their patients.

"They will just seek care anywhere they can even though they have insurance, they could afford to get into a clinic. But when it's your health, you have a rash, you have a cough, you don't want to wait," said U of M medical student Brittney Lemke.

"You don't want to see someone else, you want to see your doctor and so I think we are just going to run into problems with people using avenues of care that they are not designed to be used for," Lemke said.

"With all of the new people coming on to Medicare and Medicaid, that's a real issue," said U of M medical student Peter Meyers.

The current doctor shortage is not the only problem. One in three Minnesota doctors will retire in the next 10 years. There is also a shortage of training positions for new doctors.

"As medical schools are trying to increase enrollment by upwards of 30 percent, graduating students are left with no increase in positions available to them for their training in residency," Walsh said.

"So the number of residency positions is not keeping pace with the growth of our medical school graduates. And so it's a bottleneck that's actually restricting our ability to produce the number of positions necessary to meet the demand in the community," Andrews said.

The Affordable Care Act attempts to fix the problem by investing nearly $168 million to add more residency spots. The money is meant to train 500 new primary care doctors by 2015. However, those numbers don't match the shortage.

"I believe this is the right direction, I think that we are all playing catch-up, and need to recognize that there is on average 7 or 8 years that may pass before today's medical students or those entering medical school graduate to actually provide the care that's necessary. And we are already behind the 8 ball on that," Walsh said.

The shortage of nurses is significantly worse. More than half of the nursing workforce is close to retirement. The nation could face a shortage of 800,000 nurses by 2020.

Click here for more information on how the Affordable Care Act could impact emergency departments.