By CityTownInfo.com Staff
August 5, 2009
If advocates of health care reform manage to muscle a legislative remedy through Congress this year, they could face a huge practical hurdle. The nation is already coping with a dearth of primary care providers, say experts. Expanded access to health care could aggravate the problem.
Take the pool of physicians, for starters. There now exists a 30 percent shortage of primary care doctors and an alarmingly low proportion--less than 10 percent--of last year's medical school graduates opted to follow that career path, reports Time magazine.
Former Health and Human Services Department Secretary Donna Shalala flagged this gap in service during a recent interview with NPR. "The shortage is related to primary care," Shalala told the radio network's Scott Simon. "We have lots of specialists in the country."
The former Clinton Cabinet member suggested two cures for this chronic health care problem. Besides training more primary care doctors, Shalala urged, reformers should push for expanded use of nurse practitioners, who already provide some of the same services as physicians. "With all the advanced-practice nurses that we have in this country and more to be trained, there is a special role for nurses in our expansion of health care for all," Shalala told NPR.
Indeed, nurse practitioners have been pressing for their inclusion in health care reform bills being crafted by lawmakers on Capitol Hill, reports Time. As a result, one House health-reform bill cites not only doctors, but also nurse practitioners and physicians' assistants as primary-care providers.
Nurse practitioners bring a distinctive approach to health care that matches the outlook of reform advocates. They are trained to draw on interpersonal skills and preventive medicine when treating patients. "In the United States, we are so physician-centric in our health system," American Nurses Association president Rebecca Patton told Time. "But it should be about wellness and prevention, not about procedures and disease management."
Rural areas, already short of doctors, are poised to feel the greatest need for extra medical providers, in the wake of future health care reform. Another report from NPR highlighted the lack of health care among many rural residents, who comprise a quarter of the U.S. population, but are served by just 10 percent of its doctors. Some 23 percent more rural Americans than urban dwellers work for small businesses and 11 percent fewer get health coverage through their jobs, according to statistics gathered by NPR.
With the primary care gap seen to grow nationwide, meanwhile, nurse practitioners are hoping the need for their services and the health care reform movement will put pressure on the states to remedy the current crazy quilt of state regulations that govern how they provide services, Time reports.