By Jessica Tobacman, Special to the Tribune
March 27, 2013
The estimated 29 million people who are required by federal law to buy health insurance next year will spark a demand for more physicians and other primary care providers in some parts of the nation that won't be met quickly, according to a new study.
The study by Dr. Elbert Huang, of University of Chicago Medicine, and Howard Finegold, an analyst in the U.S. Department of Health and Human Services, found that there are parts of the nation, including economically troubled Chicago neighborhoods such as Englewood, where there is a significant shortage of primary care providers.
This shortage will likely become more acute in these areas when the federal health care overhaul law's mandate that uninsured people buy coverage goes into effect in 2014, the study found. For example, the Englewood neighborhood will see the demand for primary care physicians grow by 10 percent, the study concluded.
"There is an incredible need for providers by 2014," said Huang, an associate professor of medicine at the U. of C.
The 29 million people who buy health insurance next year will lead to about 26 million more doctor visits each year, the study found. This heightened demand will create a need for 7,200 more primary care providers.
"The … study found small problem areas throughout the country. In general, almost every state has at least one small area where there will be an extreme shortage of providers," Huang said. "Doctors grow like trees; they take a long time to develop. The solution is not likely to be to produce more doctors."
There is good news, however, Huang said.
"The country needs thousands more providers. But relative to the base-line supply, we only need 2 percent more doctors. I think most people would be surprised that the Affordable Care Act (the health care overhaul law) will not be that disruptive nationally," said Huang, who served as a senior adviser in the Office of the assistant secretary for planning and evaluation in the Department of Health and Human Services from 2010 to 2011. The department is implementing the new health care law.
In the short term, doctors might want to expand their practices to serve the growing demand, Huang said. The health overhaul law also offers physicians bonuses for treating a greater number of Medicare patients, he said.
"The hope is that they'll see more patients and continue to see them for longer," Huang said.
The study, published last month in the journal Health Affairs, will be presented in May at the Association of American Medical Colleges' ninth annual Physician Workforce Research Conference.
Dr. Namratha Kandula, assistant professor of medicine at the Northwestern University Feinberg School of Medicine, said she thought the study was well done.
"Unlike previous studies, it looks at small-area variation in the demand and supply for primary care doctors. Most other studies use state-level data and miss important differences that are occurring at a smaller-area level," Kandula said.
"For example, other studies might conclude that Illinois, overall, is not going to suffer a severe shortage of primary care doctors. However, this study looked at more granular data and found that poorer neighborhoods in Chicago will have a much greater physician shortage than wealthier Chicago neighborhoods. This finding is really important because it shows that social inequality, which is increasing in the U.S., can manifest in different ways."
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