Why Obama's physician shortage fix may not be enough

President Barack Obama's budget proposal does not go far enough to address the physician shortage. And without solving the shortage, meaningful healthcare reform is impossible, argues an opinion piece in Fortune.

Obama's budget proposal aims to incentivize going into primary care in rural and underserved areas, but it is a "timid response to a looming crisis," writes Shawn Tully, Fortune's senior editor-at-large. Demographic trends indicate the primary care physician (PCP) shortage will only get worse, Tully writes, which means in the scramble for the best PCPs, a few large chains build an oligopoly.

"The game today is, 'He who gets the most primary care doctors wins,'" Merritt Hawkins Executive Vice President Travis Singleton told Fortune.

The $500 million annual investment in the proposal is too small to fix the underlying problem--the limited number of U.S. residency positions, Tully writes. "Over the past 17 years, a few hospitals have established new residency programs for primary care doctors, raising the number to around 27,000," Tully writes. "Meanwhile, the U.S. population has risen by 50 million."

Only about 7,000 of these doctors per year enter primary care, according to Tully, as PCPs make significantly less than specialists (although another recent study suggests the gap in pay between PCPs and specialists is narrowing). And although the budget proposal targets rural areas, about half of Merrit Hawkins' searches for PCPs are in areas with populations of more than 100,000, according to the piece.

To solve the shortage in the long term, Tully writes, the government should increase funding for both residency positions and licensing for qualified doctors who completed programs in other countries, while encouraging hospitals to train more PCPs. "The reigning concept contradicts itself: providing universal healthcare while limiting the essential personnel needed to provide it," Tully writes. "Without fixing the doctor shortage, reforming the healthcare system is a fantasy."

To learn more:
- read the opinion piece