California has been at the forefront of ObamaCare implementation, but state lawmakers are facing a major obstacle: There aren’t enough doctors in the state to treat the expected influx of newly-insured patients.
A government council has recommended a physician-to-population ratio of 60 to 80 primary care doctors per 100,000 residents. Only 16 of California’s 58 counties reach this recommended supply of primary care physicians.
With ObamaCare, it’s only going to get worse.
The huge influx of newly-insured patients with ObamaCare is not the only reason for this lack of doctors. In a recent Physicians Foundation Survey, 13,575 doctors were asked how the passage of ObamaCare has affected their feelings about the future of healthcare in America. 59.3% of those surveyed said they were “less positive” about the future of American healthcare.
More than half of these physicians plan to cut back on patients, switch to cash only, or quit in the next three years. In fact, 60% of doctors surveyed said they would retire today if they could.
So, what’s California’s solution to this lack of doctors?
Redefine who can provide healthcare. Broaden the definition of “primary care provider” to include physician assistants, pharmacists, and even optometrists.
Doctors say this could greatly threaten patient safety. But, at a meeting for healthcare advocates this past December, Diana Dooley, Secretary of the California Health and Human Services Agency, said “We're going to have to provide care at lower levels. I think a lot of people are trained to do work that our licenses don't allow them to.”
What’s more important: access to care or patient safety?
National Conference of State Legislatures has reported about 350 laws altering the scope of practice of health professionals have been enacted nationwide in the last two years.
The California Medical Association says healthcare professionals should not exceed their training, but they have a different solution: Increase funding to expand participation in a loan repayment program for recent medical school graduates. The hope is that such a program may provide an incentive for these new doctors to practice in under-served communities in order to pay off their loans.
Regardless, such a program cannot increase the number of physicians in the short-term. According to Paul Hensler, Kern Medical Center’s Chief Executive, California is “going to have to get a whole lot more creative about how care is provided.”