Analysis of a Pertinent Healthcare Issue

Physicians play a key role in healthcare service delivery. The US healthcare demand has been on the rise at a record pace with the aging population and increased number of the insured population due to the Affordable Care Act (ACA), piling pressure on the workforce. Simultaneously, the United States is also facing an acute shortage of primary care physicians, with the number of those graduating not meeting the demand. This study explores the shortage of primary care physicians (PCP) as a national healthcare issue or stressor in the US health care system.

Shortage of Primary Care Physicians and Primary Care Capacity

Physicians have constituted the greater majority of professionals conducting a diagnosis, treatment, and prescription of medications to patients for the better part of modern American medicine. However, the physician supply is developing relatively slow despite the rapid increase in the demand for medical services, which is anticipated to increase even more rapidly soon. Study shows that physicians’ supply is constrained primarily by two factors: the long training duration, which is short-term, and the limited medical school capacity and few accredited residency positions in the long run (Auerbach, Straiger & Buerhaus, 2018).

The “Association of American Medical Colleges (AAMC)” projected only a small increase of 0.5% in the number of medical graduates annually between 2016 and 2030; a growth that is far slower than the rate of the increased demand in the healthcare services (Auerbach, Straiger & Buerhaus, 2018). The new data published by AAMC in June 2020 projected that the United States healthcare system is likely to experience a shortage of between 21,000 and 55,200 physicians, primary care physicians in particular, by 2033. The estimates form part of the overall projection by researchers of a deficit of between 54,000 and 139,000 primary and specialty physicians (Kondic et al., 2020). Because of the shortages of physicians, most healthcare services are provided by nurse practitioners (NPs) that form the vast part of the “advanced practice registered nurses (APRNs)” and physician assistants (PAs). However, the number of NPs and PAs is growing quickly, aided by a shorter training period than physicians alongside fewer institutional limitations in expanding educational capacity. For instance, residencies are not required for APRNs. Studies show that NPs and PAs provide care overlaps with care provided by primary care and other specialty physicians (Auerbach, Straiger & Buerhaus, 2018).

A Brief Summary of the Two Articles on Shortages of Primary Care Physicians

Fodeman and Factor (2015) article explores the potential solution to the acute shortage of primary care physicians in our healthcare systems. According to the authors, primary care physician shortages continue to pose a significant challenge to the American healthcare systems. As millions of Americans get insured under the Affordable Care Act and Patient Protection, the shortage is more likely to continue growing. Approximately 52,000 more PCPs will be needed by 2025 to bridge the widening gap between providers and healthcare service seekers. About 33,000 of the number will be required to respond to population growth, 10,000 due to the aging population, and 8,000 because of insurance expansion (Fodeman & Factor 2015).

In their study, Petterson et al. (2015) focused on residency expansion necessary to evade the forecasted primary care shortage by 2035. The authors argued that the number of primary care doctors would increase by over 44,300 by 2035. However, the primary care setting’s production rate will not meet this demand, leaving a gap of about 33 000 primary care doctors needed. About 1,700 primary care residency slots will be essential by 2035. The 10% shrinkage in population ratio for every main care physician will necessitate about 3000 slots by 2035 while lowering the retirement age to 64 from 66 years will need over 2,400 additional slots. The researchers advocated for the expansion or transformation of residency training to address the looming crisis of physician shortage (Petterson et al., 2015).

Strategies Used To Address the Organizational Impact of Physician Shortage

Fodeman and Factor 2015 proposed increased stress on primary care by the government and the medical schools as the starting point strategy to solve the physician shortage in healthcare. The government, for instance, should focus on building new medical schools and enhancing the capacity of the existing ones. Osteopathic medical schools emphasizing on primary care career is another potential solution. Internal medicine residency and outpatient rotations in medical schools also require strengthening. Policymakers also have a role in making primary care attractive through payment reforms, for instance, shifting the emphasis from procedural specialties to primary care (Fodeman & Factor 2015).

On the one hand, Petterson et al. (2015) advocate for the expansion or transformation of residency training to address the ongoing shortages in primary care physicians. The “Council on Graduate Medical Education” in 2013 recommended an increase in residency slots by 3000 in such for high-need physician specialties such as general internal and family medicine. A transformation in graduate medical training payment is also recommended to further support and motivate primary care physicians (Petterson et al., 2015).

When some of the above strategies are implemented effectively, the occupational stress exacerbated by physicians’ shortages in the healthcare organizations will be partly addressed. Psychological stress and other effects of job stress, such as burnout and treatment errors, occur in most healthcare organizations, including my organization, due to shortages of the workforce; hence, strategies to address the workforce shortage may reduce some of these problems.

Conclusion

This study has focused on the shortage of primary care physicians (PCP) as a national healthcare issue or stressor in the US healthcare system. There is a shortage of PCPs in the US amidst the growing population of aging adults, increased number of insured people under the Affordable Care Act and Patient Protection. Several strategies, including an increased emphasis on primary care training, transforming PCP payment, and expanding residency slots are fronted to help address the crisis.