A new Senate report released on Tuesday says the U.S. needs 16,000 additional primary care doctors just to meet the current need.
The report from the Subcommittee on Primary Health and Aging noted that fewer than one in three doctors in America practices primary care today, and said that if nothing changes by 2025, the physician shortage is expected to grow to about 52,000.
Primary care doctors take care of people's general health problems – a cold, a headache, pain, the flu, trouble sleeping at night. If they're unable to treat a patient using their knowledge and the resources available to them, primary care doctors will make a referral to a specialist. That's someone who has expertise in a particular area: the heart (cardiologist), the brain (neurologist), the feet (podiatrist) – the list is long.
The doctor shortage is felt "most acutely" in rural and low-income urban areas, wrote the report's authors – that means places like South Los Angeles.
"The evidence is clear that access to primary health care results in better health outcomes, reduced health disparities, and lower spending, including on emergency room visits and hospital care," said the report, adding that nearly 57 million Americans "live in areas where they do not have adequate access to primary health care due to a shortage of providers in their communities."
How bad is the shortage?
In 2011, about 17,000 doctors graduated from medical schools across the U.S. Even though more than half of annual patient visits are to primary care doctors, only 7 percent – not even one in 10 – of the graduating class had chosen a career in primary care.
The increase in the number of specialists and decrease in their primary care counterparts is problematic in part because primary care doctors are "the portal of access to the specialist," said Nina Vaccaro, the executive director of the Southside Coalition of Community Health Clinics, in September. She also noted that the "patient load is probably more significant for primary care doctors than it is for specialists."
But according to the Senate report, virtually "all the growth in the number of doctors per capita over the last several decades has been due to a rise in the number of specialists."
Which is to say: We're getting plenty more doctors – just not the ones we need.
That may be due to the "larger paychecks" specialists receive, said the report's authors – which become more enticing upon the realization that medical school graduates leave school with an average debt of more than $160,000. Over the course of their career, specialists are expected to earn as much as $2.8 million more then their colleagues in primary care.
With the advent of the Affordable Care Act's coverage expansion – which is expected to swell the number of those with access to health care by 1 million in California alone – the doctor shortage is a looming problem that's not getting any smaller or less urgent. The report's authors called it a "moral responsibility to ensure primary care access now and into the future."
Not surprisingly, the report noted that community health clinics are an important part of the solution. Federally-qualified clinics serve much of South L.A.'s population, and have been found to be as good as or even better than private medical practices.
Photo by UIC Pharmacy via Flickr Creative Commons.