Value-Based Care News

How Physician Shortages Are Transforming Healthcare’s Future

The concept of restructuring the physician landscape over the next decade must be a primary focus if the healthcare industry is to be saved.

By Jacqueline DiChiara

- Just as Rome was not built in a day, neither is a doctor. Training a physician can take up to a decade; the Colosseum was perhaps ironically built in less time.

primary care physician shortages affordable care act

With predictions of massive physician shortages gaining headway across the healthcare industry, how is overall physician and patient focus changing? Can the healthcare industry be rebuilt in a decade?

Why are physicians pulling a disappearing act?

There may soon be up to 31,000 fewer primary care physicians and up to 63,000 fewer non-primary care physicians, estimates The Association of American Medical Colleges (AAMC). Surgical specialists are reportedly among the ones most likely to close their doors.

Physicians are perhaps increasingly overwhelmed by declining profits. The total number of independent physicians has decreased from 57% in 2000 to 39% in 2012.

Nearly half of physicians who quit treating patients within an active medical practice choose to do so because of regulatory and administrative burdens, says the Texas Medical Association (TMA). Nearly one-quarter of physicians quit because of ICD-10 implementation challenges.

Around half of physicians over the age of 60 may reportedly retire because of ICD-10 claims being denied or delayed. Nonetheless, with reports of ICD-10 implementation thus far generally smooth, perhaps it is uncertain to what extent such claims will become a reality.

Within the next ten years, there could be up to 90,000 fewer physicians nationwide. Those patient populations residing in either rural areas or inner cities already facing physician shortages are perhaps expected to be hit the hardest.

With employee costs for health insurance rising, high deductibles increasing, and out-of-pocket costs on the up and up, healthcare consumers are actively searching for alternatives regarding their healthcare options.

Greater transparency may be an answer. Some leading organizations, such as the Centers for Medicare & Medicaid Services (CMS), are responding to this need with its “Doctor Lookup” feature and the Hospital Quality Star ratings system, both of which may still have some kinks to work out along the way.

Is throwing ACA money around the answer?

One apparent strategy to help alleviate the possibly devastating physician shortage aftermath is through sizable multi-million dollar Affordable Care Act (ACA) funding efforts to help coerce people to enter the healthcare field through generous scholarships and loan repayment systems.

The Department of Health and Human Services (HHS) awarded over $240 million last month, including nearly $176 million in ACA funding, to help strengthen the primary healthcare workforce.

Awards include a $23 million grant for nursing students in exchange for a minimum two-year work agreement and $11 million in loan repayment for those completing a primary care residency in rural and urban areas.

These financial awards are designed to encourage more people – i.e. registered nurses, physician assistants, as well as physicians – to pursue degrees and employment within the healthcare space.

Faculty loan repayment is also part of this deal as professor shortages across the board have been reported. Adjunct professors, even those at prestigious private research universities and the like, may be feeling this sting the most as those with multiple degrees and impressive resumes are often struggling to maintain job security and earn enough to make a decent living.

HHS’s faculty loan repayment system offers over $1 million to help keep health professions educators from leaving their faculty positions behind, although it is perhaps not yet known if such is enough to make a sizable impact.

Are concierge physicians the secret to success?

What’s next? Perhaps the latest focus is the widespread implementation of concierge services where physicians’ revenue may be advantageously stimulated by premium charges for personalized physician care.

Aside from those working within the healthcare space, patients may now be exploring more affordable options with a greater focus on meeting preemptive care needs.

For a monthly or yearly fee, patients can receive an interactive medical experience, including access to a medical spa, nutritional counseling, and fitness and wellness services.

Direct physician access via email or cell phone may also be included. Other options include same-day appointments and round-the-clock care.

The average annual fee for concierge services is between $1,400 and $1,700 per patient, says the Heritage Foundation. Two out of three concierge practices reportedly charge no higher than $135 monthly per patient.

Seven percent of primary care physicians – i.e. internists, family doctors, and pediatricians – offer direct pay/concierge medicine, reports the Physician Foundation in a 2014 physician survey with 20,000 respondents.

Thirteen percent of respondents say they plan to transition to this type of practice to some extent, either in whole or in part. Additionally, 17 percent of those physicians age 45 or younger confirm they will make this transition in due time.

Affordable direct primary care may be becoming a more mainstreamed option within both the short-term and long-term future of the healthcare industry.

The concept of restructuring the physician landscape over the next decade and keeping not only physicians, but perhaps even more importantly, those who teach physicians, from leaving needs to be one that remains active on the radar of healthcare executives if the healthcare industry is to be saved.