Black doctor examines patient’s wrist

By Akeya Dickson, NNPA Washington Correspondent

WASHINGTON (NNPA) – As more people become covered as a result of the Affordable Care Act recently upheld by the United States Supreme Court, the current shortage of physicians is expected to worsen, according to medical experts.

“We have a looming shortage of primary care physicians in this country,” said Esther Dyer, executive director of National Medical Fellowships. “Within the next five to six years there will be a shortage of at least 40,000 primary care physicians.”

But that was expected before last Thursday’s landmark court decision that paves the way for 32 million newly-insured Americans to begin receiving health services.

The Association of American Medical Colleges now says the physician shortage is “projected to climb to more than 90,000 by 2020.”

Physician shortage is hardly a news flash but certainly a reality now. Health care professionals and advocates have long advocated solutions for reversing the physician shortage, including  loan forgiveness and scholarship programs to assist potential medical students.

Further complicating the physician shortage is the roughly 80 million baby boomers aging into retirement. With a shortage of doctors opting to go into primary care and the fact that many of the existing primary care doctors are baby boomers themselves only compounds the problem.

The medical community has called for an increase of the number of government-supported residencies to help replace some of those retiring physicians and the Association of American Medical Colleges hopes to increase medical school enrollment 30 percent by 2013.“More medical students are going into specialties versus primary care. Many students are choosing other careers in terms of choosing specialties,” said Dyer. “Being the top cardiology surgeon is not the only health care provider option.”

Despite the expected rush of millions of new patients entering the system, many medical professionals have expressed enthusiasm about the court decision. Dr. Cedric Bright, president of the National Medical Association, which represents Black physicians, said in a statement released the day of the ruling:

“The ACA is working. More seniors can now afford their meds. Young people can stay on their parents’ health plans until age 26,” said Bright, who is also the Assistant Dean of Special Programs and Admissions in the Department of Medical Education at the University of North Carolina at Chapel Hill School of Medicine.

He added, “Insurers no longer deny coverage because of pre-existing conditions, or drop people because they get sick. We are doing a better job of coordinating care, and we now have better prospects for preventing chronic disease.”

Health Affairs magazine, in a report, titled “The Affordable Care Act’s Coverage Expansions Will Reduce Differences in Uninsurance Rates by Race and Ethnicity,” found that 21.6 percent of African-Americans are without health insurance, compared with 13.9 percent of Whites and 33.3 percent of Latinos.

Overall, 50.3 million Americans are uninsured, a figure that is projected to drop to 26.4 million now that the Affordable Care Act has been upheld. Medicaid and the Children’s Health Insurance Program (CHIP) coverage will account for “disproportionately large gains in coverage” among Black people. An 8.4 percent increase is expected in coverage of Black people by these two programs, rising to 36.5 percent.

There is an acute shortage of physicians of color

According to data from Kaiser Permanente, while 14 percent of the population is Black, only four percent are physicians. Similarly, 16 percent of the population is Latino, while only five percent of physicians are Latino.

“There are more patients from underserved communities starting to enter into the health care system because of health care reform,” said Yvette Radford, a member of the National Medical Fellowships board and vice president for external and community affairs for Kaiser Permanente Northern California. “We’re going to need more doctors to be able to provide quality and culturally-sensitive health care.”

On June 7, Kaiser Permanente announced that it will commit $1 million to support the educating of Black and Latino medical students in an effort to provide these new and existing patients with care from people who understand them culturally.

In exchange for working in communities in need for two years full-time, the National Health Service Corps will repay up to $60,000 in student loans for primary care physicians. The state-funded New Jersey Primary Care Practitioner Loan Redemption Program repays up to $120,000 in student loans in exchange of at least four years of service in underserved areas such as Trenton and Gloucester.

There are more than 1,300 convenient care clinics in the country that could help offset the demand. Also known as walk-in clinics or retail clinics such as Walgreens’ Take Care Clinics, they tend to be open longer hours, are in drugstores and grocery stores, and address relatively minor issues such as bronchitis and ear infections.