Increased Access to ??
Access to medical insurance is not the same as access to medical care. Access to medical insurance was the objective of “Obamacare”. The second issue, access to medical care, has not been addressed at all.
Here in Iowa, access to medical care is getting tougher to find. Primary Care Physicians are retiring faster than they are being replaced. Nurse Practicioners and Physician Assistants are increasing, but nowhere near fast enough to fill the vacancies. Nearly 40% of the MD and DO docs are over 60. We are slowing down and many will soon retire. We are decreasing the number of healthcare providers while adding access to insurance to another 40,000,000 people. How will this help access to medical care?
We have been told that “midlevel providers” are the answer. The Nurse Practicioners and Physician Assistants I have worked with are bright, dedicated professionals. We have added dozens in Iowa each year. Nationally we need tens of thousands annually, to meet the increasing needs of the millions of aging “Boomers”. It takes at least 6 years beyond high school to train an NP or PA. While that is less than the 11 year minimum for an MD or DO, 6 years is a long time. We have barely begun to build the schools and faculties to handle the increase.
Nationally we are short by hundreds of thousands of nurses (RN + LPN), yet waiting lists are years long to get into nursing schools.
The challenge of access to actual healthcare services is just beginning. Getting literally millions of new providers at all levels trained and delivering care needed to be addressed years ago. Lets get to it.
Jay Ginther, MD