By Jason Fodeman, MD and Phil Factor, DO
The American Journal of Medicine, August 4, 2015
A primary care physician shortage currently exists in this country. As millions get health insurance under the Patient Protection and Affordable Care Act, this shortage is likely to grow. It is imperative that leaders recognize the need to grow primary care capacity. This piece will explore solutions to increase primary care capacity in the United States.
The Kaiser Family Foundation estimates that 8073 additional primary care physicians are required to eliminate Primary Care Health Professional Shortage Areas from the United States in 2014. Petterson et al forecast that the United States will require 52,000 more primary care doctors by 2025; the majority (33,000) will be needed because of population growth; aging and insurance expansion will require an additional 10,000 and 8000, respectively. These estimates are based on current practice patterns and do not consider that physician panel sizes may be smaller in the future, which would amplify the primary care physician shortage. To compound matters further, primary care physicians now work part-time more frequently and are retiring at an earlier point in their careers than in the past.
Solutions to increase the number of primary care physicians have been proposed. Increased emphasis on primary care by medical schools is a common starting point. This is being done through opening of new medical schools with novel curricula with earlier integration of clinical experiences. Another expanding source of primary care physicians is the rapid growth of osteopathic medical schools that stress primary care career paths. Existing allopathic schools are exposing medical students to primary care at an early stage. Beverly et al found that a week-long primary care course favorably affects the perceptions of first year medical students toward the specialty. More research will be needed to determine whether this type of exposure influences selection of primary care career paths. Certainly these will help, but it is likely more will need to be done to solve the problem.