Health system reform (HSR) has never been attempted in the face of the "deep and persistent" physician shortages developing in the United States. Furthermore, it is "untenable to believe that the large increases in spending that are contemplated by insurance reform will not be matched by substantial increases in the demand for physicians."
Those are among the conclusions the Physicians' Foundation, a national health care organization that represents the interests of physicians, reached in a report issued as Congress debates reform proposals. The report, Physicians and Their Practices Under Health Care Reform, raises questions about the impact of socioeconomic factors on access, quality, and cost of medical care in the United States. It also highlights several concerns that the authors believe the debate ignores. These include physician shortages and the changes in physicians' practices that a reformed system would require. The report warns that the nation could be "short 200,000 physicians by 2025, 20 percent of the needed workforce, and these shortages will continue to deepen."
Among the report's recommendations are that Congress should help expand medical schools and remove the cap on Medicare's support of residency positions and that academic leaders and health insurers should find an equitable payment formula for graduate medical education that encompasses all payers.
A team of physicians and economists headed by Richard Cooper, MD, professor of medicine and senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania, prepared the report. You can read the full report or an executive summary on the Physicians' Foundation Web Site.
TMA Executive Vice President/Chief Executive Officer Louis J. Goodman, PhD, president of the Physicians' Foundation, says the report gives Congress and the president vital information they must consider as they make decisions that "will impact doctors, their patients, and the entire health care delivery system for many years to come, if not forever." He added that the report shows that today's health care system doesn't have the resources or workforce to handle the load of new patients that would come with universal access.
Dr. Cooper says it is clear "that without adequate numbers of physicians, the health care system cannot function effectively; without adequate attention to the structure of physician practices, the system cannot function efficiently; and without adequate attention to the pervasive social determinants of health, it cannot function economically."
Action, Sept. 15, 2009