The best electronic health record on the planet isn’t going to help anybody unless a physician uses it. The HITECH incentive scheme should enhance the woefully poor EHR uptake rates among US providers, as should innovative vendor business models that remove cost-barriers which have prevented many from getting in the game.
But there’s an even more fundamental issue, which is a looming manpower shortage among the ranks of US primary care physicians, a topic we’ve covered numerous times, most recently here. There simply aren’t enough physicians to use those EHRs!
Communities across the nation have long suffered from a lack of PCPs. The problem is expected to worsen as baby boomers age and the number of medical students who enter primary care continues to drop. If nothing is done to change current trends, the Association of American Medical Colleges estimates our country will be short 21,000 and PCPs in 2015 and a whopping 47,000 in 2025.
Now, finally, something is being done. And while it may not be enough, it certainly points us in the right direction. More importantly, it sets a precedent for future interventions by the federal government.
This Wednesday, Department of Health and Human Services Secretary Kathleen Sebelius announced $250 million worth of new investments designed to support the training and development of more than 16,000 new primary care providers over the next five years. The investments were mandated by the Affordable Care Act, that controversial health care bill signed into law by President Obama in March.
“These new investments will strengthen our primary care workforce to ensure that more Americans can get the quality care they need to stay healthy,” Sebelius said in a press release. “Primary care providers are on the front line in helping Americans stay healthy by preventing disease, treating illness, and helping to manage chronic conditions. These investments build on the Administration’s strong commitment to training the primary care doctors and nurses of tomorrow and improving both health care quality and access for Americans throughout the country.”
According to HHS, the investments will be used as follows:
Creating additional primary care residency slots: $168 million to train 500 new primary care physicians by 2015;
Supporting physician assistant training in primary care: $32 million to train 600 new physician assistants, who practice medicine under the supervision of a physician, and can be trained more quickly than a physician;
Encouraging students to pursue full-time nursing careers: $30 million to encourage 600 nursing students to attend school full-time which will increase the likelihood they complete their education;
Establishing new nurse practitioner-led clinics: $15 million to cover operating expenses for 10 health clinics that help train nurse practitioners. The clinics will be located in medically underserved communities.
Encouraging states to plan for and address health professional workforce needs: $5 million to fund state programs designed to expand their primary care workforce by 10-25% over the next 10 years.
In addition, the Health Resources and Services Administration will direct some federal dollars towards repayment of the loans held by medical school graduates who choose to practice primary care in medically underserved communities. Grants will also be given to community colleges, Hispanic-serving institutions and historically black universities, which were recently ranked as the top producers of primary-care doctors. Students will be able to tap new financial aid, and health professionals working in underserved areas will get expanded tax benefits.
The AAMC’s Atul Grover said the feds’ plan was a laudable, if not altogether comprehensive effort to address the PCP manpower shortage.
“It’s just a small first step, but it’s a step in the right direction,” Grover told the Washington Post.
Glenn Laffel, MD, PhD
Sr. VP Clinical Affairs
Practice Fusion EMR
