GRAPEVINE, TEX. – The combination of the aging baby boomers, growing minority populations, and the millions of Americans who will gain coverage under the Affordable Care Act, will stress the U.S. health care system and create a "crisis of access to care" in the near future, warned Dr. Cecil B. Wilson, president of the American Medical Association.
Dr. Wilson, who recently spoke at the annual meeting of the Society of Hospital Medicine, said there is already a physician shortage in many areas and specialties, but it is likely to get worse if steps aren’t taken to recruit more young people into medicine.
"The situation is serious for the patients who do not have or cannot get a physician’s care," he said. "It also presents considerable challenges for those of us in medical practice as well."
Dr. Cecil B. Wilson
Right now, the AMA estimates that there will be a shortage of at least 125,000 physicians by 2025. The problem is not just the number of the physicians but who they are and where they practice. Some of the greatest physician shortages are in rural areas and in minority communities. Recruiting minority physicians has been a challenge, he said, in part because of the high cost of medical school, but also because there are few minority role models in the medical community. And the result is that health care disparities are increasing, Dr. Wilson said.
There has been some good news, Dr. Wilson said. The Affordable Care Act includes some provisions to address these issues, including bonuses to primary care physicians to help deal with the pay differential with specialists, loan repayment programs, and a provision to shift unused residency slots to primary care. And medical schools are expanding. In the past 3 years, nearly two dozen new medical schools have either been opened, announced, or sought accreditation, Dr. Wilson said.
But there not has been a parallel growth in residency training slots. With the cap on federally funded residency positions, it’s difficult to expand training programs, he said. One possible solution is to move to an "all-payer system" that would be financed not just by Medicare, but also by insurance companies and others with a stake in the health care system, Dr. Wilson said.