Medicine
Researchers at the American Academy of Family Physicians' Robert Graham Center (which produces the Policy One-Pagers series for American Family Physician) recently predicted in the Annals of Family Medicine that a combination of population growth, aging, and insurance expansion from the Affordable Care Act will create the need for an additional 52,000 primary care physicians by the year 2025 - an increase of nearly 25 percent over the current workforce. Since the vast majority of internal medicine residents plan to pursue subspecialty rather than generalist careers, family medicine will be called on to supply the bulk of this looming gap in physician supply and demand. Recent efforts to increase the supply of family physicians include emphasizing community-based clinical training in medical school and temporarily increasing Medicaid and Medicare primary care fees.
Another strategy for bolstering the family medicine pipeline, contained in the Affordable Care Act, is mandating redistribution of unused residency positions to primary care programs. Unfortunately, an analysis published this month in Health Affairs concluded that a similar Medicare graduate medical education reform in 2005 not only failed to significantly boost primary care, but actually resulted in training twice as many new subspecialists. Dr. Candace Chen and colleagues conclude:
Our findings suggest that redistribution [of unused residency positions] largely supported hospitals in growing their specialty training. Some hospitals even converted primary care positions to specialty positions after receiving newly redistributed positions. ... This shifting collectively perpetuates the nation's physician workforce maldistribution, and our analysis demonstrates that Medicare continues to support these hospitals and even increases its support for them, regardless of the specialty mix of residents trained.
Not everyone agrees that meeting the future health needs of the U.S. population will require a massive influx of family physicians, however. Other researchers have argued that the widespread adoption of team-based care, "advanced access" scheduling, and replacing some in-person with electronic visits could provide enough new patient capacity to prevent a family physician shortage. Still, much uncertainty surrounds this and other projections. What steps is your doctor's practice taking, if any, to meet the anticipated needs of so many new patients? Hiring more physicians? Re-designing how they provide care? Please feel free to share your thoughts and stories.
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The above post first appeared on the AFP Community Blog.
- Gme Funding Must Be Targeted To Primary Care
Much of the cost of training physicians is currently borne by Medicare (and, to a lesser extent, Medicaid). This is known as Graduate Medical Education, or GME, funding, and it pays some, all, or more than all (depending upon the hospital and based...
- Primary Care, Medical School Debt, And Us Health Needs: Analysis From The Graham Center
. Bob Phillips MD, Executive Director of the Robert Graham Center, the American Academy of Family Physicians’ (AAFP) DC-based policy center, gave one of the plenary speeches at the recent annual meeting of the Society of Teachers of Family Medicine...
- Training Rural Family Doctors
. In a recent report from the University of Washington’s WWAMI Rural Research Center, “Family Medicine Residency Training in Rural Locations”,[1] Chen et. al. repeat their 2000 study of rural training in the US. They note that this is very important...
- Primary Care Training: Follow The Money
Training any kind of doctor is time-consuming and expensive, but the way teaching hospitals are financed often means that it is more profitable to open a subspecialist residency program than one in primary care. In a previous post, I reviewed a Robert...
- Tackling The Problem Of Too Few Family Physicians
Researchers at the American Academy of Family Physicians' Robert Graham Center have estimated that the U.S. will require 52,000 additional primary care physicians by 2025 due to the effects of population growth, aging, and insurance expansion....
Medicine
Conflicting views on the need for more family physicians
Researchers at the American Academy of Family Physicians' Robert Graham Center (which produces the Policy One-Pagers series for American Family Physician) recently predicted in the Annals of Family Medicine that a combination of population growth, aging, and insurance expansion from the Affordable Care Act will create the need for an additional 52,000 primary care physicians by the year 2025 - an increase of nearly 25 percent over the current workforce. Since the vast majority of internal medicine residents plan to pursue subspecialty rather than generalist careers, family medicine will be called on to supply the bulk of this looming gap in physician supply and demand. Recent efforts to increase the supply of family physicians include emphasizing community-based clinical training in medical school and temporarily increasing Medicaid and Medicare primary care fees.
Another strategy for bolstering the family medicine pipeline, contained in the Affordable Care Act, is mandating redistribution of unused residency positions to primary care programs. Unfortunately, an analysis published this month in Health Affairs concluded that a similar Medicare graduate medical education reform in 2005 not only failed to significantly boost primary care, but actually resulted in training twice as many new subspecialists. Dr. Candace Chen and colleagues conclude:
Our findings suggest that redistribution [of unused residency positions] largely supported hospitals in growing their specialty training. Some hospitals even converted primary care positions to specialty positions after receiving newly redistributed positions. ... This shifting collectively perpetuates the nation's physician workforce maldistribution, and our analysis demonstrates that Medicare continues to support these hospitals and even increases its support for them, regardless of the specialty mix of residents trained.
Not everyone agrees that meeting the future health needs of the U.S. population will require a massive influx of family physicians, however. Other researchers have argued that the widespread adoption of team-based care, "advanced access" scheduling, and replacing some in-person with electronic visits could provide enough new patient capacity to prevent a family physician shortage. Still, much uncertainty surrounds this and other projections. What steps is your doctor's practice taking, if any, to meet the anticipated needs of so many new patients? Hiring more physicians? Re-designing how they provide care? Please feel free to share your thoughts and stories.
**
The above post first appeared on the AFP Community Blog.
- Gme Funding Must Be Targeted To Primary Care
Much of the cost of training physicians is currently borne by Medicare (and, to a lesser extent, Medicaid). This is known as Graduate Medical Education, or GME, funding, and it pays some, all, or more than all (depending upon the hospital and based...
- Primary Care, Medical School Debt, And Us Health Needs: Analysis From The Graham Center
. Bob Phillips MD, Executive Director of the Robert Graham Center, the American Academy of Family Physicians’ (AAFP) DC-based policy center, gave one of the plenary speeches at the recent annual meeting of the Society of Teachers of Family Medicine...
- Training Rural Family Doctors
. In a recent report from the University of Washington’s WWAMI Rural Research Center, “Family Medicine Residency Training in Rural Locations”,[1] Chen et. al. repeat their 2000 study of rural training in the US. They note that this is very important...
- Primary Care Training: Follow The Money
Training any kind of doctor is time-consuming and expensive, but the way teaching hospitals are financed often means that it is more profitable to open a subspecialist residency program than one in primary care. In a previous post, I reviewed a Robert...
- Tackling The Problem Of Too Few Family Physicians
Researchers at the American Academy of Family Physicians' Robert Graham Center have estimated that the U.S. will require 52,000 additional primary care physicians by 2025 due to the effects of population growth, aging, and insurance expansion....