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Feb 2016

Is There a Doctor in the House?

Nobody wants to wait five months to see their primary care doctor. But with so many patients, and not many doctors, it’s no wonder you’re scheduling your July physical so far in advance.

As you may have heard, there are worries that the Affordable Care Act will create a massive physician shortage. The most obvious reason is that new patients may flood the health care market, which is already stretched a bit thin. The second reason for concern may take a few years to measure because the average time to train a primary care physician is 10 to 11 years. But as physicians have more work for less pay, it has been projected that primary care physicians may retire at a much younger age, but with fewer trained physicians to fill their place.

A 2009 survey found that the number of U.S. medical school students going into primary care practice had dropped 51.8 percent since 1997, according to the American Academy of Family Physicians (AAFP). Those are the classes of physicians that would be filling the retiring physicians’ shoes in 2017-2020.

Already, there are just 91 working primary care physicians for every 100,000 Americans, according to numbers from the Association of American Medical Colleges (AAMC) released at the end of 2015. Better put, that means each primary care physician would be responsible for 1,099 patients. And that is just a current average with the number slightly falling.

Geographically, the numbers get worse as you move south. States like Massachusetts, Minnesota and Michigan remain above the primary care physician average, but a desperate need is growing in the southern states such as Texas, Arkansas, Georgia, Alabama and Mississippi. These were states with 64 to 78 primary care physicians per 100,000 people.

But there is another reason it takes so long for a person to see their primary care physician – administrative burden.

The 2014 Medical Economics Physician Practice Study found that primary care physicians saw a major drop-off in their average number of patient visits per week, despite the number of hours worked by the doctor remaining steady. Primary care physicians reported an average of 89 patient visits per week. That is down from 99 visits per week in 2013. Internists reported a drop from 93 patient visits per week in 2013 to 85 visits in 2014. In 2015, the median number of hours worked per week by primary care physicians was 51, while internists reported 52 hours. That’s roughly the same as it was in 2013.

This is especially poignant in light of the growth of the senior citizen population. Seniors are the largest consumers of primary care physician visits. There are roughly 78 million Baby Boomers born from 1946 to 1964, who began turning 65 years old in 2011. We are at the tip of the iceberg right now.

Primary care physicians are the front line in preventive care. A good primary care doc can manage chronic conditions and cut off future health issues that would come at a high cost to the patient. As more patients are scheduling their appointments and fewer doctors are entering primary care, it leaves one wondering, “Is there a doctor in the house?”

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