California, the state that first attempted to implement President Barack Obama’s health care overhaul, has realized there aren’t enough doctors to care for the large influx of newly insured patients.
The Los Angeles Times reports that only 16 of the state’s 58 counties meet the federal government’s recommended standard of primary care physicians, and almost 30 percent of California’s doctors are close to the retirement age – the highest percentage nationwide.
“We’re going to be mandating that every single person in this state have insurance,” Democratic state Sen. Ed Hernandez told the Los Angeles Times. “What good is it if they are going to have a health insurance card, but no access to doctors?”
Hernandez has led an effort in the state legislature to expand the definition of who can provide health care services to patients. Lawmakers have proposed allowing physician assistants to treat more patients and permitting nurse practitioners to have independent practices.
Also, pharmacists and optometrists could become primary care providers and be allowed to treat some chronic illnesses.
“We don’t have enough providers,” said Beth Haney, president of the California Association for Nurse Practitioners, “…so we should increase access to the ones that we have.”
However, proposals to expand patient treatment options have been met with resistance from doctors, who say that such reforms could jeopardize patient safety and increase costs to patients.
“Patient safety should always trump access concerns,” Dr. Paul Phinney, president of the California Medical Association, told the Times.
This fight over who can treat patients to meet the growing demand for medical services is ongoing in other states, as well. The Times reports that in the past two years, approximately 350 laws redefining what health professionals may treat have been enacted across the country, and more than 50 proposals have been put forward in 24 states since the beginning of this year.
To alleviate the problem, the California Medical Association has suggested expanding participation in a loan repayment program for medical school graduates, which now gives doctors as much as $105,000 for working for three years in under-served communities.
“We’re not going to produce thousands of additional doctors in any kind of short-term time frame,” said Democratic state Assemblyman Roger Dickinson. “It makes sense to look at changes that could relieve the pressure that we’re going to undoubtedly encounter for access to care.”