At least this is slightly a more
balanced approach with both sides having realistic projections. I
will only say that I agree that there will be a doctor shortage, but
maybe not primary care doctors, as least as big as is being
projected.
The shortage will be severe in
geriatric doctors. These are the doctors that will be needed to care
for the baby boomers that are increasing every day. Geriatric means,
pertaining to elderly persons or the aging process. Primary care
doctors are not qualified to handle geriatric medicine, especially
those with multiple diseases or chronic conditions. Some will be
needed for those with single conditions, but geriatric doctors should
be in charge of these patients. Read this article in WebMD as they
present their points.
Many medical groups, led by the
Association of American Medical Colleges say they think the shortage
will be close to 130,000 in the next 10 to 12 years. It is the
health care economists that are less convinced. They say that
concerns that the nation faces a looming physician shortage,
particularly in the primary care specialties, are common. An expert
panel of the Institute of Medicine (IOM) wrote in a report that the
committee did not find credible supporting evidence of a severe
physician shortage.
As many as 10,000 baby boomers are
becoming eligible for Medicare every day. And older people tend to
have more medical needs. Everyone thinks that the Affordable Care
Act (ACA) is creating millions of patients, but they may soon see
that the ACA is driving millions of patients away from coverage and
doctors. There are more of these predictions every day and one radio
program that I listen to sporadically has callers that are
complaining about not being able to afford the new Obamacare
insurance with the high premiums and high deductibles.
I can agree there will be a mismatch
but maybe not in the doctors needed, but in the location of these
doctors. New doctors seem to cluster in the northeastern part of our
country and in or near the larger cities. The medical associations
or doctor organizations are crying for more primary care physicians,
but they are crying for the wrong doctors. Doctors of geriatrics
will be needed for the aging population and not primary care doctors.
Yet, the medical associations don't see it that way.
Many primary care doctors cannot take
care of complex elder patients and handle the combinations of chronic
conditions they are likely to have. Some of the larger medical
practices may have doctors or specialists to care for them, but most
in smaller and rural communities will be ill trained and equipped to
handle these patients.
In some geographical locations, many
services can be provided by primary care doctors, but in other
locations, physician assistants, nurse practitioners, and even
pharmacists and social workers will need to be included in the mix.
.
Currently, physicians who are
specialists make considerably more than those who practice primary
care, which many experts say is a huge deterrent to doctors becoming
generalists, particularly when they have large medical school loans
to pay off. However, “team-based care,” where a physician
oversees a group of health professionals, is considered by many to be
not only more cost-effective, but also a way to lower the number of
doctors the nation needs to train.
What may happen in the future is
unclear with doctors and economists making their predictions. Some
areas of the country will be well served and the seniors well taken
care of medically. It is the rural areas that I am concerned about
where there will be single practitioners serving the Medicare
patients. Traveling over 150 miles to see a doctor may not be
possible. Until telemedicine is authorized and the rural states have
internet connections for everyone, seniors may actually be in danger
of being harmed.
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