"The state of America's health care is poor," Jeffrey P. Harris, MD, FACP, president of the American College of Physicians (ACP), reported today at the annual State of the Nation's Health Care briefing.
"There are too many uninsured and underinsured people. We have too few primary care physicians."
"The problems are big, so the solutions must also be big," Dr. Harris declared. At the briefing, ACP provided recommendations on how President Obama and Congress can take immediate, sustained, and dramatic steps to provide affordable and accessible health care to all Americans and provide every American with access to a primary care physician.
The Institute of Medicine (IOM), a private, non-governmental organization, recently announced that the U.S. needs 16,000 more primary care physicians just to meet the needs of currently underserved areas. The shortage will grow to 40,000 or more physicians, assuming current rates of health insurance coverage, according to two recent studies. At a time when America's aging population is increasing, the demand for general internists and family physicians will continue to grow at a much faster rate than primary care physician supply, in the absence of policies to immediately and substantially increase primary care workforce capacity.
"Giving all Americans an insurance card will not guarantee that everyone will have access to care," Dr. Harris emphasized. "There are not enough primary care physicians to care for them."
To underscore the importance of the timing, Dr. Harris added: "Given the fact that it takes a minimum of seven years to train a primary care physician (medical school and residency combined), the U.S. cannot afford to delay implementation of policies to attract more new physicians to primary care and to sustain those already in practice."
Therefore, policies to expand primary care workforce capacity need to be implemented immediately and go hand-in-hand with coverage expansions. We need to act now to influence the career choices of medical students and physicians already in residency programs, and the retirement and career decisions of primary care physicians already in practice."
The ACP recommendations also call for: - Setting specific goals for increasing primary care, including policies to achieve them and measures to evaluate their success;
- Reforming primary care payment policies to achieve market competitiveness with other specialties, including immediate and sustained increases in Medicare fee-for-service payment;
- Expanding the Patient-Centered Medical Home, and
- Issuing an Executive Order by President Obama to assure that all federal agencies are working together to set primary care workforce goals and the policies necessary to achieve them.
ACP's briefing cited several examples of how patients will suffer if health care reform does not expand the primary care physician workforce capacity at the same time as coverage is expanded: