Primary Care Doctor Shortage Expected in US

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The Association of American Medical Colleges has expanded openings for first-year medical students through 2018 to combat a nationwide shortage of doctors. However, experts feel it may not be enough, particularly in inner-city and rural areas.

The Center for Workforce Studies estimates that by 2025, the US will face a shortfall of almost 160,000 doctors in all areas. Primary care is expected to be the hardest hit, as more medical students are choosing to specialize in a particular clinical area, such as cardiology or surgery. According to the Annals of Internal Medicine, 20% more internal medicine residents are opting for specialty training compared to 20 years ago. Family medicine programs are filling 15% fewer first-year residency positions than they did just 10 years ago.

With the proposal to provide a federal medical insurance plan, the current level of physician coverage will not be enough to meet the demand of an additional 31 million Americans who seek health care. In addition, the aging population keeps many patients seeking care of both primary care doctors and specialists.

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“Do the math”, said Steven Safyer president and chief executive officer at Montefiore Medical Center. “You give millions more people insurance and it adds up to a much worse shortage.”

Last year, there were 16,721 fewer primary care doctors than needed to serve at least 17 million people in inner city and rural areas, according to the U.S. Health and Human Services Department. Congress has capped medical residencies at about 90,000 since 1997 as a way to curb rising medical costs. According to data filed by the Medicare Payment Advisory Commission, federal insurance plans pays about $100,000 a year for each residency, costing the program about $9 billion overall.

On December 5, Democratic Majority Leader Harry Reid, along with Senator Charles Schumer of New York and Senator Bill Nelson of Florida, submitted an amendment to the healthcare legislation that would add 15,000 residences at a cost to Medicare of about $1.5 billion.

On December 14th, the Annals of Internal Medicine published a report to propose initiatives to address the doctor shortage. The authors propose a link between primary care graduate medical education and care for the underserved in community health centers. They propose that this could be achieved by establishing primary care teaching centers in which residents would receive their final year of training, and then go on to practice in an underserved area with a debt repayment incentive through the National Health Service Corps.

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