The shortage of primary care physicians is set to worsen in the coming years, as the U.S. population grows older, increasing demand, and a fewer physicians choose to enter internal medicine and family medicine, diminishing capacity.
However, this gap in primary care has been "mislabeled as a physician workforce shortage," according to a report in Health Affairs by Thomas Bodenheimer, MD, an adjunct professor in the Department of Family and Community medicine at the University of California, San Francisco, and Mark Smith, president and CEO of the California HealthCare Foundation in Oakland.
The more proper term, the authors say, is a demand-capacity mismatch. "Primary care practices could greatly increase their capacity to meet patient demand if they reallocate clinical responsibilities…to nonphysician team members and to patients themselves," the authors wrote.
Here are three solutions the researchers gave to close the demand-capacity mismatch without creating more primary care physicians.
1. Use nonclinician licensed practitioners and other personnel. Licensed practitioners such as nurses, pharmacists, psychologists, clinical social workers, physical and occupational therapists and health educators can be used to fill some roles usually performed by physicians. To be used effectively, these workers need to be empowered to provide certain services, the authors noted. Other workers, like medical assistants, front desk staff, health coaches and patient navigators can also be used more frequently.
2. Encourage patient self-care. When patients care for themselves, it decreases demand for physician care. Already, patients can take pregnancy tests at home, for instance, and diabetes patients can monitor their blood pressure. To further self-care, patients with certain chronic conditions can serve as peer coaches for other patients with the condition.
3. Embrace technology. The authors highlighted innovations in telemedicine as one technological advancement spreading through healthcare. Other, yet-to-be-developed technological advancements could enhance patient self-care and reduce the demand for primary care physicians.
"Licensed and nonlicensed personnel, patients and technology can add enormous capacity and reduce demand to narrow the demand-capacity gap," the authors wrote. "The new world can liberate physicians from protocol-based tasks that could be performed by less trained people or well-programmed computers, allowing physicians to do what they love."
More Articles on the Physician Shortage:
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10 Cities With Largest Physician Shortages