Doctor shortage, increased demand could crash health care system

Approximately 48 million people are currently uninsured in the United States

CNN News Wire | 10/2/2013, 12:48 p.m.
Obamacare is expected to increase patient demand for medical services. Combine that with a worsening shortage of doctors, and next ...

Obamacare is expected to increase patient demand for medical services. Combine that with a worsening shortage of doctors, and next year you may have to wait a little longer to get a doctor’s appointment. And the crowded emergency room may become even more so.

There are approximately 48 million uninsured people in the United States. When the mandatory insurance rules of Obamacare kick in next year, and a couple dozen states expand who is eligible for Medicaid, you can bet more people are going to want to use their health benefits.

In fact, so many people were anxious to get access to health insurance — many for the first time — when the insurance marketplaces opened Tuesday, more than a dozen of the websites experienced technical glitches.

Dr. Ryan A. Stanton is worried that this coming flood of newly insured patients may crash the U.S. health care system as well. Stanton works at the emergency room at the busy Georgetown Community Hospital right outside of Lexington, Kentucky.

While he sees trauma cases often, a good number of the patients he sees aren’t actually emergencies. They’re the uninsured who can’t afford to pay for a regular doctor’s visit — so they use the emergency room instead.

“We now see people without health insurance coming in for their regular checkup here,” Stanton said. “We can’t turn anyone away like a doctor’s office could. ... I worry though with (Obamacare) this will significantly increase patient volume.”

There is already a national shortage of doctors, according to the Association of American Medical Colleges. We’re down about 20,000 now, and the number is expected to drop; nearly half the nation’s physicians are over age 50 — meaning many are at or near retirement age.

“Keep in mind the Affordable Care Act didn’t create this crisis,” said Dr. Reid Blackwelder, president of the American Academy of Family Physicians. “We’ve got an aging population that needs more care and a growing population.”

A study in the Annals of Family Medicine journal projected the country will need 52,000 more primary care physicians by 2025. Most of those extra doctors are needed because of projected population growth. But the problem also begins in training; only one in five graduating medical residents plan to go into primary care, according to the Journal of the American Medical Association.

Stanton said he might have been interested in primary care rather than emergency care, but the lower pay kept him away. Doctors on average graduate with hundreds of thousands of dollars of debt. Specialists make more money.

“Primary care is the backbone of our medical system, but most people I know in medical school can’t afford to go that route,” Stanton said.

If the popularity of the insurance marketplaces on the first day they opened is any sign, there will be a lot more people in Kentucky fighting to get a doctor’s attention. Problems plagued the Kentucky exchange site until midafternoon, but still more than 1,200 people had purchased policies or enrolled in Medicaid by the end of the day, according to a spokeswoman for the Cabinet for Health and Family Services.