Doctor shortages produce a number of problems for the surrounding community. Lack of access to medical services, prohibitive travel times, and lack of medical consultation are just some of the challenges residents in medically underserved areas (MUAs) face. As more baby boomers hit retirement age and begin to seek healthcare services more frequently, the need for primary care physicians is increasing, as is the need for specialists in many different fields, from geriatrics to orthopedics. Based on current projections, we may be facing a shortage of over 40,000 physicians by 2020, which may produce a number of medically underserved areas around the country.
The Affordable Care Act of 2010 (also known as Obamacare or the ACA) has further complicated the problem of medically underserved areas by mandating that all small business owners with 50 or more full-time employees must provide health insurance for their full-time employees. The Affordable Care Act has also established an individual mandate requiring individual uninsured citizens to either purchase a public option plan or pay a financial penalty to opt out of their health insurance obligations. The Small Business Health Options Program (SHOP) as well as the online marketplace (healthcare.gov) was established to address consumer concerns during the application process for these programs.
This means that nationally, the patient-to-physician ratio may increase to a point where several additional parts of the US may be considered medically underserved areas. Hospital administrators and healthcare industry advocates nationwide are working on ways to transform our healthcare delivery system’s infrastructure to be able to withstand the massive projected influx of new patients over the coming decades. One possible solution involves expanding access to nurse-practitioners, medical professionals who have many of the same medical privileges as licensed physicians. Under such a system, routine problems would be treated by nurse-practitioners, thereby lowering the number of primary care physicians needed to meet patient demand.
As the Affordable Care Act evolves over the coming years, we will most likely see amendments designed to address physician shortages in other ways, such as direct incentives for physicians and nurse-practitioners to serve for a set period of time in medically underserved areas. The Affordable Care Act may eventually afford nurse-practitioners with additional freedoms when attending patients in order to increase efficiency of healthcare delivery, but these new systems are likely to have tracking mechanisms in order to both uphold medical standards and document any errors that significantly affect the patient’s course of treatment.