A Democratic California state lawmaker introduced a package of bills Wednesday to address an expected doctor shortage as the state prepares to insure millions of new patients under federal healthcare reforms.
Sen. Ed Hernandez of West Covina said his bills would expand services that can be provided by nurse practitioners, optometrists and pharmacists in order to help alleviate a shortage of primary care physicians, particularly in rural areas and inner cities dominated by minorities. The bills are SB491, SB492 and SB493.
Hernandez, an optometrist, said his bills would allow nurse practitioners to see Medicaid and Medicare patients even if the doctors they work for do not.
Optometrists could check for high blood pressure, and pharmacists could order laboratory testing to detect diabetes.
"Here in the state of California, we have a capacity issue," he said. "We have a workforce shortage."
The California Medical Association opposes the bills, said spokeswoman Molly Weedn. The group representing 35,000 doctors believes the state should focus on building more medical schools, adding residency slots and expanding programs that help doctors pay off student loans in exchange for working in underserved communities.
Starting in 2014, California will help millions of uninsured people gain access to healthcare in two key ways: Through a new insurance marketplace that will offer subsidies and tax credits to individuals and small business; and by expanding Medicaid, the federal-state health program for low-income people. The program is called Medi-Cal in California.
Hernandez, who unveiled his bills at a safety-net clinic in Sacramento, said the measures are not meant to replace doctors but to increase access to care for ethnic and poor communities as California's healthcare system braces for a huge influx.
Dr. Francisco Aguirre, chief medical officer at WellSpace Health, said he supported the bills because he has a hard time recruiting physicians. He relies on nurse practitioners just as much as doctors to treat the poor.
"I worry about having enough providers to care for our patients," Aguirre said. "I am hopeful that this legislation will increase the available pool of providers."
Hernandez isn't the only lawmaker trying to tackle the provider gap.
State Sen. Fan Pavley, D-Agoura Hills, has put forth SB352, which seeks to expand services that physician assistants can provide.
A 2011 report by the Association of American Medical Colleges said California is likely to face a physician shortage in 2015. Only 16 of the state's 58 counties have the recommended supply of primary care physicians.
The doctors association said there's also a shortage of specialists in nearly half of the counties.