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Health Reform and the Shortage of Primary Care Doctors

Ready or not, love it or hate it, the Affordable Care Act, also known as Obamacare, is the law of the land. Some provisions are already active, with most others becoming effective on January 1, 2014. State health insurance exchanges, where consumers and small businesses can shop for and purchase policies, are scheduled to open on October 1, 2013. Between paying customers buying policies on the exchanges, and the law’s expansion of Medicaid, Obamacare will result in between 16 and 32 million newly insured patients entering the American healthcare market by 2016.

America’s Doctor Shortage: The Coming Storm?

But are there enough primary care doctors to treat everyone? The Association of American Medical Colleges estimates that the United States is short about 20,000 physicians right now. As it stands, approximately 20% of patients face inadequate access to primary care because there are simply too many patients and not enough primary care doctors to go around.

Obamacare proponents argue that the new law did not cause the physician shortage, pointing instead to the greying of America, skyrocketing medical tuition, and allegedly stingy insurance reimbursement rates. As America gets older, its doctors age along with the rest of the population; nearly 50% of physicians in the U.S. are over age 50. Additionally, burdened by heavy student loan debt, many new physicians are eschewing primary care for more lucrative specialty fields.

While Obamacare did not cause the primary care doctor shortage, both sides of the healthcare reform debate agree that the influx of newly insured patients will exacerbate it. Some experts estimate that the U.S. doctor shortage will increase to 30,000 physicians by 2025. The situation has both health reform critics and proponents fearing that both the currently insured and new patients will face long lines and long waits, assuming they can find primary care physicians to treat them at all.

States and Medical Schools Scrambling to Meet Demand

As full implementation of the Affordable Care Act quickly approaches, American medical schools and U.S. states are on the front lines of ensuring there is an adequate supply of medical professionals to meet patient demands. Some states, such as California, have legislation in the works to expand the duties of nurse practitioners and other paraprofessionals. However, such legislation is controversial, and even if it passes, there are concerns regarding whether patients will accept seeing a paraprofessional in lieu of a doctor—or simply head straight to the nearest (already burdened) emergency room. Meanwhile, medical schools cannot turn out physicians as quickly as America needs them; it can take up to 10 years to train a new doctor.

Technology Could Provide Relief

The best solutions to the primary care doctor shortage may come from the free market. Retail health clinics, often located within large drugstore chain stores, are growing rapidly. However, these clinics are usually staffed not by physicians, but nurse practitioners.

For years, the healthcare industry has largely not taken advantage of the Internet; despite nearly universal online access among Americans, most physicians do not consult with patients online, insisting that they come into the office. The best possible answer to long lines and crowded waiting rooms is for doctors to embrace technology. Websites such as [client name redacted] allow patients to consult with a nationwide network of physicians via email, 24 hours a day, 7 days a week, with no waiting and no lines. Such services are a win-win for doctors and patients. Doctors get to consult with more patients, in less time and with lower overhead expenses, and patients get prompt access to physicians at affordable rates.

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