Think tank offers recommendations for expanding primary care rolls

As reform discussions steam on, one issue that keeps popping up is how the system will generate enough primary-care physicians to cope with the influx of newly-insured patients. 

It's not just a long-term planning issue either. In Massachusetts, patients faced waits of weeks, or even months, to enter primary-care practices in the wake of state reforms. These kind of waits could be disastrous if they're widespread nationally, as they undermine the system's ability to nip serious illnesses in the bud.

This week, another organization published a set of recommendations on how to boost the supply of primary-care physicians. The Center for American Progress, a D.C.-based think tank, offer the following ideas:

* Legislators should expand the National Health Service Corps, a program launched in 1972 that offers scholarships and loan-repayment options to primary-care, dental and mental-health providers who agree to work in areas where there are shortages of these providers. This could do much to boost the staff of community health centers, which provide care to many who have no other options, they note.

* Private and public insurers should change the way primary-care physicians are paid to better reflect care delivered. This approach, which attempts to turn primary-care doctors into "team leaders" rather than just high-volume service providers, may include paying medical home fees and offering incentives for improved patient outcomes.

* Widen the role of nurse practitioners and physician assistants, and convince private health plans to cover their services more broadly. NP and PA training takes half as long as it does for physicians, and costs only 20 to 25 percent of cost of medical school, so their services are far more likely to be available.

While none of this is revolutionary, the Center has done the job of emphasizing and clarifying key points that bear repeating. Without a primary care expansion, health reforms could stumble, and ultimately, patients could be harmed by lack of access. The truth is, it may not take revolutionary ideas to address the primary care shortage; simply executing on practical solutions may just do the trick.

To get more information from the Center:
- read its report on the PCP shortage

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