Several critiques of the Affordable Care Act, AKA Obamacare, argue that expanding access to health care, if it happens, could result in a shortage of doctors. The argument is a bit intuitive, insofar as of course increasing the number of people with access to medical care will require more medical practitioners to treat them. The other option would be to limit the number of people who go to the doctor, which is the problem the law was trying to fix. Welcome to the American health care debate in an election week.
New systems, which could become more common under Obamacare, could make physician shortages 50 percent less acute by 2025.
However, a RAND study has found that the Affordable Care Act may address the problem, at least in the short term, by moving the U.S. toward medical care delivery systems that rely more on physician assistants and nurse practitioners for many tasks, rather than MDs. At Forbes, a health writer, Bruce Jepson, looks into the details, and finds the RAND conclusions pretty watertight. RAND looked at two "emerging models of care," the patient-centered medical home and the nurse-managed health center, "both of which use a provider mix that is richer in nurse practitioners and physician assistants than today’s predominant models of care delivery." The new systems, which could become more common under Obamacare, could make physician shortages 50 percent less acute by 2025, the RAND paper claims.
Does this mean a doctor's assistant will be doing your appendectomy? Rather, most of the models, writes Japsen, "use nurse practitioners and physician assistants to reach out to the patients, making sure they are taking their medications, eating properly and adhering to doctor’s orders." The result is a system that will "put medical care providers together under one umbrella entity to improve quality with the doctor as a quarterback of sorts, using nurses and other caregivers to manage the medical care of populations of patients."
Whether this will come to pass is a question of how the health care market responds. But he claims, at least circumstantially, a sharp uptake in American health providers advertising for nurses.