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Health law to worsen shortage of doctors in Valley



Published: Mon, August 13, 2012 @ 12:06 a.m.

By Burton Speakman

bspeakman@vindy.com

youngstown

A shortage of primary-care physicians in the nation is expected to worsen when more than an estimated 30 million people gain health insurance by 2014 through the Affordable Care Act.

Ohio is expected to have a shortage of 5,031 of those doctors by 2020 no matter what happens with the Affordable Care Act, said Megan Smith, director of communications for the Ohio Academy of Family Physicians.

Because of the number of low-income people in the Mahoning Valley, the act will have a larger impact locally, said Rudolph Krafft, program director of the family medical residency program at St. Elizabeth Health Center in Youngstown.

“A large number of the people that we treat are uninsured or underinsured,” he said.

The key to having enough primary- care physicians is getting more medical students interested in primary care as a specialty, Krafft said.

“The problem is that primary care is the lowest in terms of pay. You can almost reverse the lowest pay list for specialties and find the most popular specialties,” he said. “These students pay so much to attend medical school, and they know it will be easier to pay off those loans with a higher-paying specialty.”

A limited number of residency openings also will make the problem worse, Krafft said. The number of students in medical schools is increasing, but the number of residency openings remains consistent.

“In a few years for the first time, there might not be enough residency openings for all U.S. medical school graduates,” he said.

Traditionally U.S. programs took foreign medical-school graduates to fill spots, but with more graduates and no additional funding for residency programs, American students may not be able to find a spot, Krafft said.

One positive aspect of the new health-care law is that people who had previously been uninsured or underinsured now can see a primary-care physician and their care would be greatly improved, Krafft said.

The act provides more in payment for primary care from Medicare and Medicaid, he said. Hospitals also will receive additional funding when and if everyone has insurance.

“Right now the hospitals already treat everyone regardless of if they have insurance,” Krafft said.

Meanwhile several initiatives in the state seek to help improve access to primary care despite the shortage of physicians, Smith said.

One of the larger programs focuses on training doctors, medical students, nurses and medical team members to deliver care as a team to support more patients, according to the Ohio Academy of Family Physicians.

The Affordable Care Act also will cause additional work in the medical community, said Tim Maglione, senior director of government affairs for the Ohio State Medical Association.

“New systems are needed to be put in place to take care of the additional people,” he said.

A team approach may be used more widely with a physician leading nurses, psychiatrists and social workers, Maglione said. Some hospitals and physician practices are working on developing this approach.

Some plans call on greater use of nurses and physician assistants to allow primary- care doctors to treat more patients, Krafft said.

The goal of the act was a good one, to increase the public’s access to health care, Maglione said, adding that several issues in the act will need to be revisited before it goes fully into effect in 2014.


Comments

1southsidedave(4777 comments)posted 1 year, 11 months ago

Everyone in America deserves medical coverage and the right to have decent treatment options...why can't our Government provide this? Too busy helping the rest of the world.

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2formerdemliberal(182 comments)posted 1 year, 11 months ago

Southside,

The government does not provide/pay for health insurance. Taxpayers do, including your middle-class pals. When low income individuals cannot pay the the Obamacare tax (er, mandate), who do you think will subsidize their premium payments? It ain't gonna only be the 1% club that you so despise. Lot's more money to steal from the middle class.

Maybe you should read the article quote that no one is ever rejected by a hospital for lack of insurance. And when they don't pay, guess whose health insurance premiums increase to cover for the losses? Employers and employees who offer and who have earned health care benefits (not a right) are already subsidizing for uninsured health care with higher premiums.

And BTW, pay attention to the article headline. If everyone has health insurance, there will not be enough supply of general practitioners to meet demand. Plus, as mentioned in the article, GPs are the lowest paid in medicine and are leaving the profession as we speak because of lower payouts from Medicare and Medicaid cuts created by the Obama administration. So you'll have your precious health insurance, but because of increased demand by new health insurance patients and fewer supplies of GPs, you'll either wait six months to see a doctor about a growing lump in your chest or be seen by doctor assistants with limited power and education to make accurate decisions about your health.

Can you tell me where a "right for decent health care and treatment options" appears in the Bill of Rights? Of course liberals conveniently forget the Bill of Right tenants and create their own agendas/rights (i.e.. the right to an abortion) to fit their power needs.

Finally, Hella BB, at least that 1 trillion+ for the Iraq war produced something moderately positive by bring some sense of democracy to the Middle East. Those troops that served in Iraq can now see the long-term benefits of their sacrifices. Do you seriously think that the recent uprisings to dictatorships in Egypt, Libya, and Syria are coincidences and have no connection that a neighboring country like Iraq now has a form of democratic rule?

In contrast, that $2 trillion debt that Obama used for his "economic stimulus package" has produced approximately 4,000 new jobs, or about $5 million spent per job with unemployment remaining above 8% for over 40 months. Couldn't that money have been better used to subsidize health care insurance?

But Bush was an evil Republican and Big Daddy Obama only wants to take care of all of his children. Somewhere between both of these fallacies lies the truth.

But of course, all Republicans are evil and all Democrats are caring, loving public servants interested in helping who cannot help themselves. Look at all of the "good" they have done for this area for over fifty years.

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3HappyBob(285 comments)posted 1 year, 11 months ago

Headline reads:
"Healthlaw to worsen shortage of doctors in valley"
What I expect of the Vindicator is to offer some facts. How many doctors will the valley be short because of the Affordable Care Act? Is the Mahoning Valley unique in this respect, or is the reluctance to go into primary care because of low pay affecting every community nationally and world-wide?

My problem is that the headline is not a statement of fact but a political opinion designed to push a political agenda.

Just because Ms Smith says that there will be a shortage of 5000 doctors for the entire state of Ohio doesn't make it so. Isn't it more correct to say that she FEARS that there will be a shortage of 5000 doctors. Moreover, she suggests that that her fears have nothing to do with the "healthlaw". The rest of the piece is speculation by Mr. Krafft based on what he anticipates medical students might do in light of the healthcare law.

Is it factual that these statements have been made by these individuals - yes, that part is factual. Are those statements factual- NO, they offer no facts to support the conclusions only their fears and apprehensions.

A less editorially biased-minded headline might read:"Fears - Healthlaw might worsen doctor shortage in the Valley". Now that would be factually correct!

Bob Elston

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4iBuck(212 comments)posted 1 year, 11 months ago

National socialist health care perversion, a.k.a. ObummerDoesn'tCare will only make the situation worse.

"the number of doctors for every 100K Americans fell from 173 in 1900 to 125 in 1930." --- Derek Bok 1993 _The Cost of Talent_ pg 30

"the number of medical doctors per 100K people dropped from 157 in 1900 to 125 by 1929... By 1985, this figure had risen to 230 per 100K."
Mary Ruwart "Harming Our Health" chapter 5 _Healing Our World_
http://www.ruwart.com/Healing/chap5.html

"By 1860, there were more than 55K physicians practicing in the United States, one of the highest per capita numbers of doctors in the world (about 175 per 100K)... By 1963, despite advances in technology and a huge growth in demand, one effect of the report was to keep the number of doctors per 100K people in the United States -- 146 -- at the same level it was at in 1910." --- Dale Steinreich 2010-05-16 "100 years of US medical fascism" _Ludwig von Mises Institute_ http://mises.org/daily/4276 visited 2012-07-04

"In 1965, there were 135 MDs per 100K Americans, only 12 more than in 1930, despite the massive improvements in the quality of medicine & the growing access to health services that had occurred in the intervening years..." --- Derek Bok 1993 _The Cost of Talent_ pg 51 (referencing Richard L. Ernst & Donald E. Yett 1985 _Physician Location & Specialty Choice_ pg 9; 1990-12-16 "Annual Report: Medical Education in the US" _JAMA_ volume 255 pg 2813)

"The U.S.A. today has just 2.4 physicians per 1K population..." --- Terry Jones 2009-09-15 _Investors Business Daily_ [240/100K]

"The national average is 293 doctors per 100K people; Arizona has 219, according to the Arizona Hospital and Healthcare Association."
Casey Newton 2010-01-13 _Arizona Republic_
http://www.azcentral.com/news/electio...
visited 2012-07-04

151 doctors/200K in 1970
http://www.barnesandnoble.com/w/what-...

216 doctors/100K in 1990
245 doctors/100K in 1997
http://www.census.gov/statab/www/stat...
http://www.census.gov/statab/www/stat...
visited 2012-07-04

253 doctors/100K in 2001
http://www.census.gov/compendia/stata...
visited 2012-07-04

266 doctors/100K in 2004
http://www.census.gov/compendia/stata...
visited 2012-07-04

267 doctors/100K in 2006
http://www.census.gov/statab/ranks/ra...
visited 2012-07-04

202 physicians/100K in USA in 2006
http://www.dartmouthatlas.org/data/ta...
visited 2012-07-04

271.1 doctors/100K in 2007
http://www.census.gov/compendia/stata...
visited 2012-07-04

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5iBuck(212 comments)posted 1 year, 11 months ago

257 physicians/100K in 2008
http://www.statehealthfacts.org/compa...
citing Health, United States, 2010 (Table 106) Centers for Disease Control and Prevention, National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/hus/hus1...
visited 2012-07-04

146 doctors/100K in 1970
165 doctors/100K in 1975
193 doctors/100K in 1980
220 doctors/100K in 1985
234 doctors/100K in 1990
262 doctors/100K in 1995
266 doctors/100K in 2000
"In 1970 there were 146 doctors per 100K people and by 2008 it hit 322 per 100K."
http://www.freeby50.com/2011/05/physi...
http://facts.kff.org/chart.aspx?ch=204
visited 2012-07-04

258.7 physicians/100K
https://www.aamc.org/newsroom/newsrel...
visited 2012-07-04

"In 1900, before widespread state restrictions, 5214 individuals graduated from medical school. That number dipped to 3047 in 1920. In 1950, there were only 5553 individuals graduated from medical school -- barely more than in 1900, despite an increase in the US population from 76M to 152M. Thus, in 1900, there were 68 individuals graduated from medical school for every 1M residents while in 1950 the number had dropped to 37. This reduction in the proportion of the population graduating from medical schools occurred as advances in medical technology were increasing the demand for physicians. By 1980, there were 15,136 graduates from medical school, or about 66/M population, which is close to the proportion from 1900... one would expect a larger percentage of the population to enter medical practice were it not for the barriers to entry created in the name of regulating product quality." --- Randall G. Holcombe 1995 _Public Policy & the Quality of Life_ pg 111 (referencing Campion _The AMA & US Health Policy Since 1940_ & _Statistical Abstract of the US_)

"From 1964 to 1980, the number of students graduating each year from medical school jumped from 7409 to 15135." --- Derek Bok 1993 _The Cost of Talent_ pg 51 (referencing Richard L. Ernst & Donald E. Yett 1985 _Physician Location & Specialty Choice_ pg 9; 1990-12-16 "Annual Report: Medical Education in the US" _JAMA_ volume 255 pg 2813)

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6iBuck(212 comments)posted 1 year, 11 months ago

"4 [new MDs] per 100K Americans in 1970 to almost 7 per 100K by 1984.  Since 1984, the number of medical school graduates has been relatively flat (see red line in bottom chart), while the population has continued to grow, causing the number of new physicians per 100K population to decline to only 5.3 per 100K by 2008, the same ratio as back in 1974.  Over the last few years the number of medical school graduates has increased slightly, and the ratio of graduates per 100K increased to 5.56 last year, the highest in a decade. " --- Mark J. Perry 2012-07-04
http://mjperry.blogspot.com/2012/07/a...

"[A] day's stay in the hospital cost 5 times as much in 1970 as it did in 1950. These incentive problems have existed since the advent of medical insurance, but the negative effects on overall health costs have only manifested themselves since WW2 because health insurance was rare before that time. In 1940 less than 10% of the US population had any health insurance, so while institutions responsible for reducing market forces in medicine were developed earlier in the century, they did not exert a major effect until insurance became more wide-spread." --- Randall G. Holcombe 1995 _Public Policy & the Quality of Life_ pg 129 (referencing Martin Feldstein 1971-12-?? "Hospital Cost Inflation: A Study of NonProfit Price Dynamics" _American Economic Review_ vol 61 pp 853-872 & Burton A. Weisbrod 1991-06-?? "The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, & Cost Containment" _Journal of Economic Literature_ vol 29 pp 523-552) [IOW, MORE health insurance drives up prices.]

graph of "professional degrees earned":
http://www.kermitrose.com/jgoEduStats...

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7DwightK(1236 comments)posted 1 year, 11 months ago

So we didn't need as many doctors when people were suffering and couldn't afford care?

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8TylerDurden(367 comments)posted 1 year, 11 months ago

2014 is going to be an eye opener for a lot of people, unless you are on medicaid and welfare now. Then you will just wait for your check each month as usual. No worries.

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9AnotherAverageCitizen(1174 comments)posted 1 year, 11 months ago

if Obama is not re-elected, then the CREATOR of Obamacare becomes Pres. Just remember, for all those that hate Obama care, it was WILLARD ROMNEY who started it.

Be careful for what you ask for.

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10doubled(210 comments)posted 1 year, 11 months ago

All you baggers who have sponged off the system for decades and now cash your social security checks each month on your way back from your doctors appointment (paid for by medicare), are now complaining that people who can afford health insurance - but just chose not to pay for it - now have to pay for it and carry their weight. Yeah, that makes a lot of sense. I've said it before, the boomer generation, esecially the older ones, are the worst generation of Americans this country has ever seen. You've accomplished nothing for this country. And now you whine about paying taxes at the lowest rate in 60 yrs - yet you still complain. As a generation, you're pathetic. Just go away and let the Xers take the lead - you've done enough damage.

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11commoncitizen(961 comments)posted 1 year, 11 months ago

WHAT???? there's something negative about Obamacare??? That can't be right it, was going to save us all!!

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