The doctor crisis: A key bill counters the looming physician shortage

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A lot of uncertainty surrounds the future of health care both nationally and locally, but one thing is beyond doubt: America needs more doctors, thousands of them.

The Association of American Medical Colleges says the country will have 62,900 fewer doctors than it needs by 2015 and the number could increase to 130,000 by 2025. The influx of previously uninsured people into the market because of the federal Affordable Care Act is responsible for some of that need, but broad demographic factors loom larger than Obamacare.

Federal funds pay for a large portion of the residency programs for doctors, and the number of slots allotted has been frozen since 1997. No matter how many medical school graduates there are, the number of training positions in U.S. hospitals stays basically the same. But the U.S. population has grown by 50 million in the last 15 years, and those people need medical care. With the biggest population bulge beginning to hit retirement age, 10,000 baby boomers are expected to retire every day for the next 20 years. Their medical needs only increase as they age, and the physicians among them are retiring, too.

Although there is no simple solution to this problem, the country can take steps now to address the shortage.

The proposed Training Tomorrow's Doctors Today Act -- introduced in Congress by Democrat Allyson Y. Schwartz of Pennsylvania, also a gubernatorial candidate, and Republican Aaron Schock of Illinois -- would help. The measure, which did not advance in the last Congress despite bipartisan sponsorship, would create 15,000 new residency positions over the next five years, a boost over the current number of roughly 115,000.

Unlike some similar measures, this bill puts the attention on increasing the number of training slots for future primary care physicians, requiring 50 percent of the positions for that purpose. The bill anticipates a particular need as the number of uninsured Americans decreases and access to care increases. In addition, the bill calls for more accountability from hospitals to demonstrate that dollars provided for doctors' training are being used specifically for that purpose.

House Resolution 1201 would solve only part of the challenge of creating the medical workforce that the country requires. Regulations that allow nurse practitioners, physician assistants and others to use the full range of their training and skills also would help alleviate the burden on primary care doctors. Changes in how doctors are compensated for care also is worth considering.

But Congress doesn't have to perform the equivalent of a medical miracle and tackle all of that when it reconvenes in Washington later this month. Members can make a real difference in improving access to health care by increasing the number of training slots for medical residents. Enacting HR 1201 would accomplish far more than voting to repeal Obamacare for the 41st time.



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