Shortage of doctors could damage healthcare reform

By Andrew Stern - Analysis

CHICAGO (Reuters) - A growing shortage of primary care doctors could place a major burden on the U.S. healthcare system if President Barack Obama succeeds in extending medical insurance to millions of Americans who currently lack it.

As healthcare legislation works its way through the U.S. Congress, most of the focus has turned to how to finance a reform that could cost $1 trillion in the next 10 years and aims to cover most of the 46 million uninsured Americans.

Less attention has been paid to what might happen if millions of new patients join a healthcare system that is unprepared and unequipped to handle the load.

The United States already has a shortage of between 5,000 and 13,000 primary care doctors, according to the Robert Graham Center. Add millions of previously uninsured people and the shortfall will balloon to as many as 50,000 doctors.

"I don't think (the doctor shortage) will be the thing that dooms the reform bill" being debated in Congress, said Dr Robert Phillips, director of the Robert Graham Center, a non-profit organization that analyses healthcare policy.

Obama and other reform advocates argue that billions of dollars and many lives could be saved by extending preventive care to many who do not now have access to it.

But some lawmakers worry that such gains may not be realized because of a lack of primary care doctors who are usually patients' first healthcare contact.

Solving the problem will take time and money.

"It's a system that's not serving our country well; we need transformative change and it's going to cost money," said Dr Cecil Wilson, president-elect of the American Medical Association, which represents 250,000 doctors.

The country needs more medical schools, more residency slots, and better pay for primary care physicians who currently make much less money than specialists, Wilson said.

Insurers routinely pay more for procedures performed by specialists than for checkups by primary care doctors. A primary care physician typically earns between $125,000 and $200,000, while specialists often earn several times more.

Some experts argue the problem is more an inefficient healthcare system than a shortage of doctors.

POOR AREAS UNDERSERVED

The Altarum Institute, another non-profit group that analyses medical policy, found affluent areas of cities tend to have plenty of primary care physicians, while poor urban areas and rural regions are underserved.

There is also a perceived shortage of nurses, who may be called upon to take on more tasks when preventive care becomes the norm.