Primary-care doc shortage leaves 62M with inadequate access: study

As national attention centers on the number of individuals who will gain insurance coverage under the health reform law, new research warns that a shortage of primary-care physicians means about 62 million Americans still have inadequate access to primary care.

That figure comes from a report by the National Association of Community Health Centers (PDF), which found that the majority of that population actually has insurance, with roughly 22% covered by Medicaid and 58% covered by other insurance. The remaining roughly 21%, the study showed, is uninsured.

“People can experience barriers to high quality, comprehensive primary and preventive care in many forms, including the availability of providers where healthcare resources are scare, the affordability of care regardless of insurance status, or the accessibility of providers who understand the culture, language, transportation challenges and preferences of the surrounding community,” the study said.

The findings also showed that without care provided in community health centers, an additional 21 million people could face primary-care shortages. And the demand for health centers—which the NACHC estimates save the overall healthcare system about $24 billion a year—is growing under health reform, the report said, adding that community health centers provide savings for the healthcare system because the care provided in these facilities is both efficient and tailored to the patient.

Meanwhile, research last week from the American Academy of Family Physicians both underscores and complements the NACHC findings. In recent policy recommendations, the AAFP suggests that the United States could end the shortage of family physicians by increasing family medicine training positions to 4,475 by 2025. To do this, the graduate medical education system would need to add 65 family medicine training positions each year over the next 10 years.

According to the AAFP, the primary-care workforce must grow about 25%, to 261,000 from 209,000, to ensure healthcare access for all Americans. The group estimates that an additional 21,000 family physicians are required to meet that need. As a result, the annual production of new family doctors would have to grow by an average of 65 per year.

Dr. Reid Blackwelder, president of the AAFP, said in a news release late last week that there is no single solution to the primary-care physician shortage, but rather it must start with medical school recruitment and continue through an improved practice environment. The group's other policy recommendations include setting aside a portion of medical school openings for students who plan to choose family medicine or other primary-care careers and preparing family medicine residents for practicing in high-functioning teams within a patient-centered medical home.

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