One way to fix the “doctor” shortage

(Flickr comedy_nose)

(Flickr comedy_nose)

There’s one way to fix the “doctor shortage” that no one seems to be talking about.

Current estimates claim that we will be short 52,000 primary care doctors by 2025. But a recent Health Affairs paper by Thomas S. Bodenheimer and Mark D. Smith, California healthcare experts, argues that we may be able to help solve the shortage without having to add more doctors.

It’s widely known that there is a shortage of primary care looming on the horizon. Even Obamacare acknowledged the problem, offering a 10 percent boost per year to primary care physicians in an effort to entice medical students to choose that specialty over more lucrative options like radiology or neurology.

But this isn’t a viable solution. Bodenheimer and Smith cite estimates that only 9 percent of medical students choose to go into primary care. Additional research by the American Association of Medical Colleges also reflects this trend – it is far more popular for students to choose professions like radiology, that offer twice the average annual salary (around $350,000 compared to $175,000).

So what can be done? “The gap can only be narrowed by empowering all team members to care for a large number of patients based on the team members’ training and abilities,” said Bodenheimer.

In the paper, the authors suggest allowing other licensed medical personnel such as nurses, psychologists, and therapists take over some of the functions of caregiving. Non-licensed personnel can have an impact too – life coaches and medical assistants can play an important role in maximizing efficiency in a doctor’s office.

By the authors’ estimates, doctors could free up 24 percent of their time by letting other team members focus on minor, straightforward tasks – everything from health advice to immunizations to diagnosis of common ailments.

This would allow doctors to focus instead on complicated medical problems, increasing their work life satisfaction while also serving more patients.

But wouldn’t this hurt patient satisfaction? Bodenheimer and Smith say no. “Research indicates that these approaches not only work, but actually tend to increase patient satisfaction compared with care by physicians,” said Bodenheimer.

It sounds like a pretty straightforward solution to the shortage. Patients would be more happy, physicians would be more fulfilled, and primary care would become more efficient.

There’s just one problem – regulation. Currently, there are many state and federal regulations that prevent healthcare providers who are not full physicians from practicing certain aspects of care. The American Association of Nurse Practitioners, for example, ranks more than half of states as “reduced practice” or “restricted practice” environments.

For nurses, medical assistants, or health coaches, the restrictions are even greater.

Obamacare could have tried to tackle this problem by reforming the way providers offer care. But instead, it tried to offer the 10 percent boost to primary care physicians as a “quick fix.” According to Bodenheimer and Smith, this change will not be near enough to solve the shortage. We should be thinking outside the box to find better ways to deliver primary care.

First published on Opportunity Lives

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