Shortage of Primary Doctors Could Derail Benefits of Affordable Care Act

With millions of patients expected to be added to insurance rolls, will there be enough primary-care physicians to serve them all?

By Jasmine Evans


With additional portions of the Affordable Care Act going into effect later this year, one serious issue could stymie the benefits for a large majority of new patients: a huge influx of new patients and a lack of doctors to care for them. According to the Association of American Medical Colleges, the influx of patients will lead to a nationwide shortage of 45,000 primary-care physicians (PCPs) by 2020. Without easy access to primary care, vulnerable populations—including the elderly and low-income underrepresented groups—stand to suffer from costly and unnecessary hospitalizations.

The problem is expected to be severe in large urban areas like New York, where officials are already sounding the alarm. In 2014, the state anticipates hundreds of thousands of new patients under the New York Health Exchange and Affordable Care Act. The influx of patients has sparked worries in the medical community that patient numbers will overwhelm PCPs, and that doctors won't understand the needs of vulnerable populations. Additionally, a shortage of doctors will also leave them with less time to spend with each patient, a problem that could have additional effects on members of underrepresented groups and low-income patients, who research has shown are less likely to open up to doctors if they don't feel understood.

Working to head off the problem, Kaiser Permanente in 2012 donated $1 million to National Medical Fellowships, a program that aims to increase the number of physicians from underrepresented groups. Further, this year, Kaiser, in partnership with the University of California, Davis, will use a $1 million grant from the American Medical Association to implement a training program for students interested in primary care. With published research showing that primary care has a larger impact on Black deaths than white deaths and that Black medical students are more interested in primary care than other racial groups, Kaiser's efforts carry significant potential to add to the corps of doctors ready to serve the newly insured. Kaiser is No. 3 in the DiversityInc Top 50.

A shortage of medical professionals is also likely to cause additional hardships to the elderly and disabled. Members of these groups will be at risk of not receiving adequate primary care because many PCPs will be able to afford to not accept Medicare—these PCPs will be in greater demand due to the increased percentage of patients covered by higher-paying insurance programs. As a result, these patients could be forced to struggle to create long-term relationships with doctors, which can be beneficial to treating their health issues. In 2012, North Shore–LIJ Health System, one of DiversityInc's Top 10 Hospital Systems, launched a program to bring home-based primary care to the elderly in an attempt to begin forging these relationships.

The AARP addresses the threat the Affordable Care Act presents to Medicare in a video series.

Exploring these issues, and the impact that diversity will play in their evolution, is an important part of the planning process for both medical and human-resources professionals. Readers who want to learn more on how to manage the issues and concerns of these new patients are invited to register for DiversityInc's upcoming event Culturally Competent Healthcare: How Diversity Creates Better Patient Outcomes in September.

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