The Physicians Foundation just released its “2014 Survey of America’s Physicians,” a biennial survey that included 20,000 responses, and let’s just say it’s not a pretty picture.
The survey says that “81 percent of physicians describe themselves as either overextended or at full capacity.” And 44 percent say they will take steps to reduce patient access.
This comes at a time when demand to see physicians is growing, as millions of newly Obamacare-covered people, and especially newly enrolled Medicaid beneficiaries, try to see a doctor. But it also comes at a time when Obamacare’s low reimbursement rates are forcing doctors to limit the number of Obamacare-covered patients they will take—if any. And that’s on top of doctors’ decade-long cutback in the number of Medicare and Medicaid patients they will see, for exactly the same reason.
Indeed, the New York Times reports that a newly released federal investigation found that half of the doctors listed as accepting Medicaid patients are not available to treat them.
A growing demand for doctors and a declining supply. A classic economic problem thanks to Democrats who voted for Obamacare. So what’s the solution?
The most likely answer is that nurse practitioners (NPs) and physician assistants (PAs) will pick up the slack, especially for primary care.
As the PBS NewsHour reported a few years ago: “The scope of what nurses can do medically has also been growing for the past decade, at a time when the pool of primary care, or family doctors, has been shrinking. … And more and more are working on their own, especially in poor inner-city neighborhoods and rural areas, where there are few doctors in private practice.”
The U.S. Bureau of Labor Statistics (BLS) predicts that demand for PAs and NPs will be strong between 2012 and 2022, growing by 38.4 percent and 33.7 percent, respectively. The median salary for PAs in 2012 was $90,930 and $89,960 for NPs.
But you can expect those salaries to rise. What is an unacceptable pay cut for physicians could be an attractive increase for the lower-earning PAs and NPs, many of whom are willing to take the lead on providing more comprehensive care.
In short, the day is likely coming when the only health care provider who will see you for primary care needs, and especially for Medicaid and Medicare, is a PA or NP.
While it may make sense to expand PA and NP responsibilities, that decision should be made from the bottom up, in the context of doctors and nurses looking for ways to provide quality patient care at a reasonable cost.
It should not be the result of top-down micromanagement and price controls that leave health care providers scrambling to find a way to survive under Washington-imposed regulations. Yet that’s exactly what happening under ObamaCare.
December 9, 2014