NCPA - National Center for Policy Analysis


November 18, 2009

Health care reform will fail to achieve its promise of affordable access to medical care unless the nation's physician workforce is substantially expanded to meet the demand that newly insured patients will place on an already over-burdened system, warns Timothy P. White, Chancellor of the University of California, Riverside.

A comprehensive strategy for growing the physician workforce  -- as well as other allied health professionals such as nurses and physicians' assistants -- should be developed and supported with a federal investment at the same time health insurance is expanded to cover millions of additional people, says White.

Without this, gaining access to prompt medical care for all patients will become even more difficult. There will be longer wait times for appointments, less face time with a physician and, in all likelihood, delayed diagnoses leading to more expensive treatment and increased risk of complications. One need only look at the experience of Massachusetts, where the adoption of universal health coverage has intensified the physician shortage, explains White:

  • Nationally, the physician shortage will persist for the foreseeable future, even without adding tens of millions of people to the ranks of insured.
  • The Association of American Medical Colleges (AAMC) forecasts a national physician shortage by 2025 of between 124,000 and 159,300, adding that universal health coverage could increase the shortage by another 31,000 physicians.

Many regions of the United States already experience severe physician shortages, says White:

  • Riverside County -- located in the diverse and rapidly growing Inland Southern California region -- is the only county in the state with a population greater than 1 million to have fewer than 100 M.D.s per 100,000 people, according to a recent report prepared for the California HealthCare Foundation.
  • Furthermore, the physician workforce does not reflect the ethnicity of the population, underscoring health disparities that result in a higher incidence of chronic diseases and higher mortality in minority and low-income populations.
  • Because minority physicians are more likely than non-minority physicians to practice in ethnically diverse communities, it is vital for medical schools to train a diverse workforce of physicians to practice with a clear emphasis on prevention, and with cultural competency and sensitivity.

Source: Timothy P. White, "Where Are the Doctors to Implement ObamaCare?" Wall Street Journal, November 17, 2009.

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