Areas With Doctor Shortage Will Be Hit Hard by Health Care Rollout

The New York Times profiles an area of California that is one of many that is severely short of doctors. A government council recommends that any given region have 60 to 80 primary care physicians, and 85 to 105 specialists, per 100,000 residents. The Inland Empire, which encompasses Riverside and San Bernardino counties, has 40 primary care physicians and 70 specialists per 100,000 residents. The area is short of every kind of physician imaginable.

Riverside is not the only area suffering from a physician shortage either. Suburban Phoenix, the Mississippi Delta, and Detroit also face similar shortages.

The Inland Empire is indeed the shortest-staffed location in California. Many doctors prefer to work in the more affluent Orange and Los Angeles counties nearby, where they can make more money. Many physicians' offices are turning away patients covered by Medicaid, which is a third of the healthcare expansion covered by the Affordable Care Act.

It is an invisible problem, experts admit. Patients still get seen, but their doctor visits are accompanied by a longer wait time and less time with their physicians. As a result, some say that people are driving increased distances to get care and over-reliance on emergency room visits (which come with their own notorious lengthy wait times).

The primary care physician has all but disappeared, in particular, as wages for primary care physicians have become far lower than those of their peers. In 2010, primary care doctors made $200,000. Specialists make twice that amount.

The Affordable Care Act should compensate with an additional 3,000 doctors. The country needs 45,000.

Experts say some things should help matters. Walk-in clinics, as well as allowing nurses to have more responsibilities, will help. The California Medical Association says that the state needs to raise Medicare payment plans to make it more economically feasible for doctors to see Medicaid patients.

More doctors may help the equation as well. The University of California-Riverside has recently founded a medical school that should start accepting students in 2013.

But even if UC-Riverside is a success, like its founders hope, it will be just a drop in the bucket. It typically takes a decade to train new doctors. Perhaps more importantly, people are not enrolling in medical school at the rate that the population is increasing.