Doctors & Health Care Reform

by admin on July 27, 2009

If Universal Health Care does pass not only will doctors drop out of the indursty, mor then they are now.


So, say everyone in the United States has health insurance. Does that now mean that everyone has access to healthcare?

Not exactly. In fact, access to healthcare providers could worsen, particularly in states like Florida, where a growing shortage of doctors and other providers is concerning many in the medical industry. And that’s without adding the increase in demand for services that surely would come with universal healthcare insurance.

Don’t just take my word for it. Speaking a few weeks ago at a conference held by the American Academy of Nursing, University of Miami President Donna Shalala, former secretary of the U.S. Department of Health and Human Services, noted the problems that could arise from a sudden increase in patient load.

`GROWING SHORTAGE’“The reality is that healthcare reform that focuses on fixing healthcare insurance without dealing with the chronic and growing shortage of physicians is likely to encounter what Massachusetts has encountered, and that is that they don’t have enough healthcare providers,” Shalala said.


In Florida, it won’t take much to tip the scale from having a situation of concern to one of crisis. Our doctors are fading away, have been for years. About two-thirds of Florida’s physicians are 46 or older, with a large percentage of those close to retirement.

And there aren’t enough young doctors in the pipeline to take their place. Only about 8 percent of the state’s doctors are 35 or younger, according to a study released last fall by the Florida Department of Health. In Central Florida, the shortage is such that Florida Emergency Physicians, an organization that recruits doctors for the Florida Hospital System, periodically scours the supply of doctors in Puerto Rico with the hope of luring them to the mainland.

The reasons for the shortage are many and complex: In the 1980s, medical schools stopped churning out enough doctors because they foresaw a glut of physicians. Those who do go to medical school find there is a shortage of residency slots to allow them to complete their training. Then there are the high liability-insurance costs. And low reimbursement rates from insurers, particularly Medicare and Medicaid, have discouraged many in the profession from practicing primary care.

Efforts are being made to address the problems. New medical schools are opening, including one at Florida International University, and the medical profession has been active in trying to ensure that any reform would come with a healthy dose of increased healthcare providers.

ELEVATE NURSESFor example, at the conference by the American Academy of Nursing (which supports reform), Shalala was part of a panel that spoke in favor of creating medical centers run by nurse practitioners, instead of doctors. Shalala was on vacation last week and unavailable to speak to me. However, at the conference she emphasized that nurses must be an integral part of any reform.


Then again, we also have a shortage of nurses.

All of which goes to show that the issue is too complex to try to rush toward solutions, which is what’s happening as President Obama seeks consensus on reform by the end of the summer.

Certainly there are ways to increase the supply of healthcare providers, and that should be the first step in a slow and phased approach to improving access to healthcare. Unfortunately, when it comes to healthcare reform, doctors aren’t the only thing in short supply.

We’d do well to first obtain more patience, rather than more patients.

Hopefully, medical school and all the requirements to become a doctor will be available to more potential medical students as Obama planned.


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