With the new health reform bill recently passed by Congress and signed into law by the President, over 32 million currently uninsured folks are estimated to be insured by 2014. While that is great news – the obvious question is who will be providing health services to these newly insured Americans.
In the state of Missouri we have six medical schools that in 2009 collectively graduated 846 new doctors. That is the good news. However, only 103 of these doctors entered family medicine in 2009 and only 34 of these doctors entered Missouri residency programs. In other words, only 12% of the doctors that graduated in Missouri schools in 2009 are going into family practice – the rest of the new doctors will concentrate on other specialty care services.
In 2009 Jeffrey Harris, MD, FACP and President of the American College of Family Physicians said in a speech that “expert research has found that nations where primary care physicians are 50% of the total physician workforce have better outcomes and lower heath care costs”. Obviously we are far away from this 50% goal in Missouri.
There are some helpful financial incentives in the health reform bill to encourage doctors to become family practice docs. Of course, in our current health system we know that specialty care doctors often times work less hours and make much more money that primary care doctors. In addition, it is anticipated that nurse practitioners will be given more prominent roles in providing primary care in order to ensure that newly insured Americans are given the quality medical and preventive care they deserve.
In order for the health reform goals to be realized — better access for all Americans to quality health care at affordable prices – not only doctors and nurses but also hospitals, pharmaceutical companies, nursing homes, social workers, insurance companies, home health providers, mental health providers, dentists, free health clinics and FQAC’s are going to have to adapt their current practices in order to provide affordable and quality health care to all Americans.