Skip to main content

Your health care is covered, but who's going to treat you?

By Jacque Wilson, CNN
updated 12:50 PM EDT, Fri June 29, 2012
Brenda Major gets a checkup from Dr. Fernanda Mercade at a clinic in Miami on March 22.
Brenda Major gets a checkup from Dr. Fernanda Mercade at a clinic in Miami on March 22.
STORY HIGHLIGHTS
  • American Medical Association expresses concern over physician shortage
  • Estimates say there will be a shortage of 63,000 doctors by 2015
  • Shortages due to lack of funding for residency programs and baby boomers

(CNN) -- When the Supreme Court upheld the Affordable Care Act in a 5-4 ruling Thursday, the American Medical Association was quick to release a statement in support of the "historic" decision that will give more people access to health coverage.

But (and there's always a "but") medical professionals across the country are wondering: When an additional 32 million Americans get medical insurance, who exactly is going to treat them?

"We've expressed some concerns before about whether or not we're going to have enough physicians out there," AMA President-Elect Ardis Hoven said.

They have good reason to worry. When Thailand enacted the "30-bhat scheme" in 2002, requiring all patients to be covered by health insurance, 14 million people were added to the country's health care system. The result was longer waits at the doctor's office and complaints of subpar service.

8 countries that have universal health care

Obama said mandate isn't tax in 2009
Health care questions answered
Health care ruling energizes voters

A physician shortage in the U.S. was expected even before the Affordable Care Act was signed into law in 2010, according to the Association of American Medical Colleges. Now the group estimates that there will be a shortage of 63,000 doctors by 2015 and 130,600 by 2025.

The shortage is a result of several factors. A large number of medical professionals are reaching retirement age, as is a large group of patients: Nearly 15 million will become eligible for Medicare in the coming years, the Association of American Medical Colleges reports.

On top of that, there is a lack of residency spots available for students graduating from medical school. In 2011, more than 7,000 were left with degrees that said "M.D." but no place to continue their education, according to the National Residency Matching Program.

Why your waiter has an M.D.

Many residency spots are funded by Medicare, and there's a cap on the number a hospital can claim each year. That number, about 100,000, has remained steady since 1997. While the Affordable Care Act will redistribute some unused residency slots and increase funding for the National Health Service Corps, more needs to be done, advocates say.

"There will be real physician shortages if we don't do more to lift the residency cap," said Dr. Atul Grover, the Association of American Medical Colleges' chief advocacy officer, in a statement. "People on both sides of the aisle have realized the need to train more doctors."

Opinion: We don't need more doctors

The biggest scarcity will be in primary-care physicians, Hoven said, thanks to better insurance coverage for preventative care.

"I would like to note that these are not newly appeared patients," she said. "They've been in emergency rooms, for things that are not necessarily an emergency. It's going to be a reshuffling of where they get their care and when they get their care."

This, of course, is a good thing, Hoven said. Doctors will be able to detect diseases earlier and focus on wellness, which in turn might lower health care costs. But that will require more internists, ob/gyns and pediatricians -- at a time when many private practices are struggling to stay afloat financially.

Nurses would be a perfect fit to handle the increase in preventative medicine practices, said registered nurse Karen Daley, president of the American Nurses Association. Nursing's holistic approach focuses on wellness and community-based health needs.

Unfortunately, America has been talking about the nation's nursing shortage since the early 2000s, and the numbers haven't improved.

"We're going to be facing serious shortages unlike anything we've ever seen in the next decade," Daley said.

The American Nurses Association was a staunch supporter of the Affordable Care Act, and the group wrote a brief in support of the legislation. Even if it's not a perfect law, Daley said, there are several important protections that have been put in place, protections that will give access to millions who otherwise might have avoided care.

But, there's always a "but."

"This is going to have to be a system that, in order to be effective, is going to have to be able to meet demands for the work force. We need more resources to provide more access."

ADVERTISEMENT
Part of complete coverage on
The Affordable Care Act
updated 1:37 PM EDT, Thu July 5, 2012
In its ruling last week on the national health care law, the Supreme Court found that penalties the law places on people who don't buy health insurance count as a tax protected by the Constitution.
updated 4:03 PM EDT, Thu June 28, 2012
The Supreme Court's decision Thursday to uphold the Affordable Care Act means that the predictions about how it will affect Americans remain in place.
updated 10:54 AM EDT, Fri June 29, 2012
With his opinion for a narrow majority of the Supreme Court, Chief Justice John G. Roberts Jr. has, for the first time since his confirmation as chief justice in 2005, breached the gap between the conservative and liberal wings of the court on a polarizing political issue.
updated 9:23 PM EDT, Thu June 28, 2012
In a landmark ruling that will impact the November election and the lives of every American, the U.S. Supreme Court on Thursday upheld the controversial health care law championed by President Barack Obama.
Here's a breakdown of the votes an what the Supreme Court justices wrote about the health care ruling.
updated 3:51 PM EDT, Thu June 28, 2012
The court's opinion, in preserving the Patient Protection and Affordable Care Act, under Congress' taxing power, still gives a virtually unlimited sway to the power of the federal government, Stephen Presser writes.
updated 1:41 PM EDT, Thu June 28, 2012
Chief Justice Roberts, in a move that likely surprised many, joined the four more liberal justices in declaring that the mandate could survive, but as a tax.
updated 11:19 AM EDT, Thu June 28, 2012
What exactly did the Supreme Court decide? Here's the nuts and bolts of their ruling.
updated 11:30 AM EDT, Thu June 28, 2012
At stake in the court's ruling is the well-being of millions of Americans living with chronic diseases such as cancer.
updated 11:25 AM EDT, Thu June 28, 2012
The Supreme Court is expected to hand down its ruling on the health care reform Thursday. What the justices decide will have an immediate and long-term impact on all Americans.
updated 5:02 PM EDT, Thu June 28, 2012
The Supreme Court is set to rule on the constitutionality of the Patient Protection and Affordable Care Act on Thursday. The landmark decision will dictate the way health care is administered to millions of Americans.
updated 11:16 AM EDT, Sun June 17, 2012
A look at key moments in the law's history from the start.
updated 11:19 AM EDT, Thu June 28, 2012
A look at the four issues the high court tackled separately during oral arguments in late March. Those issues are expected to play key roles in the judges' final decisions.
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT