Health Care Reform: Is There a Doctor in the House?

Reform could strain, or possibly improve, the primary-care experience

By Karen Pallarito
HealthDay Reporter

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Part two of three-part series

WEDNESDAY, Sept. 8 (HealthDay News) -- Health reform will put insurance cards in the hands of tens of millions of previously uninsured Americans. Many will need physicals, immunizations, preventive screening tests and care for chronic health conditions.

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So, how tough will it be to get a doctor's appointment?

Some experts worry that there could be longer wait times to see a doctor, particularly in rural areas and underserved markets where primary-care physicians are in short supply.

"The reality is there's going to be a potential primary-care crisis as health care is expanded," said Dr. John D. Goodson, an internist in primary care at Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School in Boston.

A primary-care practice is often a patient's first and ongoing contact with the medical system. Primary-care physicians are generalists trained in family medicine, general internal medicine or general pediatrics. They diagnose and treat acute and chronic conditions, provide preventive services and counseling, coordinate care and make necessary referrals to specialists.

Yet primary-care physicians make up only 35 percent of America's physician workforce, and the pipeline of fresh talent is tapering off. Fewer than 20 percent of U.S. medical students are choosing to practice primary-care medicine, according to the Council on Graduate Medical Education, which advises and makes recommendations to the U.S. Department of Health and Human Services and Congress on physician workforce matters.

Studies project a shortage of 44,000 to 46,000 primary-care doctors by 2025 unless action is taken to lure more medical students into the field and retain experienced primary-care doctors.

And future demand for generalist physicians is expected to swell as the population ages.

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