Obamacare to Produce Huge Doctor Shortage
By 2015, the United States will face a shortfall of nearly 30,000 primary care physicians, due largely to Obamacare — and a shortage of 65,800 by 2025, the Association of American Medical Colleges predicts.
The shortfall is attributable in part to deterrents to entering the field, such as relatively lower incomes compared to specialists, and the growth of the elderly population in America.
But the biggest culprit would be Obamacare. If the healthcare reform bill is not overturned by the Supreme Court, up to 33 million previously uninsured Americans will be covered by health insurance, leading to a sharp increase in the demand for medical services. And even if Obamacare is not fully implemented and merely expands Medicaid coverage, 17 million Americans will be added to the Medicaid rolls by 2020.
There is, however, a readily available solution for reducing the demand for primary care physicians, according to Dr. John Rowe, professor in the department of health policy and management at the Columbia University Mailman School of Public Health.
“One of the best ways to alleviate this shortage is to expand the scope of practice for advanced practice registered nurses (APRNs), well-trained registered nurses with specialized qualifications who can make diagnoses, order tests and referrals, and write prescriptions,” he writes in The Atlantic.
“APRNs could provide a variety of services that primary care physicians now provide.”
He cites a report from the Institute of Medicine of the National Academy of Sciences that found that properly trained APRNs can provide core primary care services as effectively as physicians.
But Rowe points to a problem: Nurses are permitted to practice “independently to the full extent of their training and competence” in only 16 states and the District of Columbia, while the other states impose regulations limiting their practice.
And the American Medical Association, the American Academy of Family Physicians, and several other professional organizations oppose expanded use of APRNs, despite recent research showing that such use would have “no impact on primary care physician income,” observes Rowe, who was previously president of the Mount Sinai Hospital and Mount Sinai School of Medicine in New York City.
He adds that nurses can be trained faster and at a much lower cost than doctors, and declares: “Tapping nursing’s potential is the fastest and least expensive way to meet growing demand for primary care.”