With a perfect storm brewing as the Affordable Care Act brings more insured patients into the system, baby boomers become older and a lack of interest in medicine as a career (especially primary care), the United States is poised to suffer a shortage of 45,000 primary care doctors and 46,000 specialists by 2020, according to the Association of American Medical Colleges.
But several efforts to ameliorate an access crisis are underway, according to an article from Stateline. Three of the most promising capacity solutions include the following:
- Use of nonphysician providers. Although expanding scope of practice for professionals such as physician assistants and nurse practitioners remain controversial in physician and dental offices, Stateline noted, efficient practices rely on using all clinicians to the top of their licenses. "Medicine is a team effort and physicians need to rely more on their staffs to engage patients with data collection, coaching and even prescribing," William T. Manard, M.D., director of clinical services in the Department of Family and Community Medicine at St. Louis University School of Medicine in St. Louis told Medical Economics. "Resistance to change comes from both sides. Doctors have to convince themselves and colleagues that they can let go of some aspects of care and let midlevels handle them."
- Savvy scheduling. Practices need to rethink the way they fill appointment slots to complement the office's natural ebb and flow. For example, instead of scheduling chronically ill patients for follow-up visits three months in advance, send reminder cards, suggested Judy Bee, a principal of PPG Consulting in La Jolla, Calif., in Medical Economics. "When patients call for an appointment, you'll have a better idea of your capacity and can adjust the schedule so that there's room for patients who have more acute needs."
- Electronic contact. Telemedicine technology and even simple electronic messaging can cut down on a lot of unnecessary volume in physician offices and help patients feel connected to their doctors. In addition, noted Stateline, clinicians can fit patients with electronic devices that remind them to take their medications and provide other guidance about their conditions.