Substitute “physician assistant” or “pharmacist” in this phrase, and this may become a commonplace introduction patients seeking medical care will hear in the future.  Why?  Legislatures throughout our nation are looking for ways to bridge a looming shortage of doctors caused by the approaching exodus of aging physicians and the increased demand for access to physician-led care by millions of newly-insured Americans, courtesy of the federal Patient Protection and Affordable Care Act (PPACA) enacted in 2010. 

Nationally, nearly one quarter (24.7%) of active physicians are age 60 or older.  It’s worse in California where nearly one-third (29.2%) of all active physicians are over 60.  And depending on which analysts’ projections one uses, starting next year, the PPACA is expected to extend either Medicaid or private health insurance coverage to between 24 and 34 million uninsured Americans—including about  four million of California’s seven million uninsured residents—all of whom will be seeking medical homes with primary care practitioners. 

Are we ready for this double whammy?   What do we do when increased demand further strains our diminishing supply of doctors? 

Currently, the average wait time for a new patient to see a doctor is 20.5 days, with Boston at 49.6 and Atlanta at 11.2 days having, respectively, the longest and shortest wait periods.  So, where do we come up with the 17,000 additional physicians many experts say are needed after the PPACA kicks in?  This is the crisis with which legislatures throughout our nation are grappling.

Some approaches worth considering include the following:

• Authorize advance practice nurses, pharmacists, physician assistants, optometrists and other allied health professionals to perform as primary care practitioners to the extent their training and scopes of practice credentials allow.
• Restructure medical education to reduce the debt burden incurred by students who pursue medical degrees.
• Identify kids in primary and secondary schools with aptitudes for clinical science and channel them to educational and career opportunities in medicine and allied health professions.
• Increase tax-supported tuition subsidies for students who want to become primary care practitioners.
• Supercharge the payment incentives in the PPACA for primary care.

Lastly, Congress must act to preserve the existing financial support provided to those hospitals that help train our future doctors.  Failure to do so will pull the rug out from under many of our nation’s physician training programs.

Your thoughts?