Primary Care Providers Shortage Proposal Coursework

Primary Care Providers Shortage Proposal
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Executive summary
The current and predicted future trends for the shortage of primary care providers, which is and will be instigated by the Affordable Care Act, and the increasing population of the nation dependant on primary care, portray a diminishing steady drop in the number of primary care providers. This continues to create a gap between the demand of the population for primary care services and the capability of primary care providers to deliver quality primary care that would meet the demand. Primary care capacity can be increased through augmenting the prevailing primary care capacity and also increasing the number of primary care providers. The former can be done through assigning and coming up with new primary care responsibilities and roles, which include; incorporating the population health as part of the primary care practice; empowering licensed health practitioners; including and assigning some roles to registered nurses and pharmacists; generating a standing order for non-licensed health practitioners; amassing the potential for more patient self-care, and harnessing technology to add towards capacity.
The numbers of primary care providers can be increased through changing the views on primary care to not only reflect greater reward and respectable income, but also prestige. This could boost the capacity of students interested in becoming primary care providers and it could also promote staffing of the population likely to choose professions in primary care like international medical graduates, osteopathic physicians and minority groups.
Organization information
This paper will present the proposal (of solutions to the shortage of primary care providers) of the medical advisor for the (NHSC) National Health Service Corps, to present and submit it to the American Board of Medical Specialities (ABMS). The NHSC is a government program that the HRSA, United States Department of Health and Human Services and the Bureau of Health Workforce manage. NHSC provides health care to those people that need it the most. It has been working since 1972 and it aims at creating healthy communities through incorporating primary health care providers to the states in the U.S that have inadequate access to health care. Currently, the NHSC has 9,600 members that deliver health care that is culturally competent to a population of about ten million. The NHSC also has 5,000 approved sites for health care in both rural and urban areas of the United States. Of the NHSC primary care providers, 1,100 of them are preparing to practice or are in residency and school. The NHSC also offers financial support to its members and awards scholarships and repayments of loans to the primary care providers that are eligible. In turn, the providers are committed to serving in the NHSC approved health sites and they may continue to serve there even after their contract expires (NHRS, 2016).
The American Board of Medical Specialities is recognized as an organization that is a not-for-profit and it attends to medical professionals and the public. It aims at improving health care quality and generating educational and professional principles for specialization and practice of medicine. Since it started working in 1933, it has developed these principles in order to support the innovations in science, technology and medicine, and make amends to the delivery process of health care. In addition, the organization is a source for information on physician certification, so that the public, educators, researchers and health care organizations can verify the certification status of a physician. The board members of this organization elevate standards and principles for the care of patients and improvements in care across all medical specialities (ABMS, 2016).
The proposal on solutions to the shortage of primary care providers would help the ABMS learn new ways of improving the health care delivery system and curb the gap between population demand for primary care services and the capacity for primary care delivery.
Background
At the end of the 20th century, the number of physicians grew from 115 per 100,000 to 190, ranging from 1965 to 1992. This broadcasted a tremendous increase among health care specialists which was 120% as compared to 14% of primary care physicians. In the mid-1990s, HMOs focused on primary care and primary care gatekeeper, and this recorded resurgence. The supply of primary care providers rose from 67 to 90 per 100,000 during this time. Graduating students preparing to pursue their careers in primary care also grew from 15% to 40% between 1992 and 1997. Unfortunately, the primary care gatekeeper and HMOs declined by 1997 and students on the path of primary care careers were soured. The gap between demand and supply of primary care widened. Another gap that widened was that of the income between primary care providers and specialists (Bodenheimer& Pham, 2010).
In an operational perspective, the context of the shortage of primary care providers, lies in the kind of work they do which is treating the patients as a whole, and this requires time in order to deal with the illness. The amount of work they do is also more than their numbers, the population of the patients requiring primary care is higher than the available physicians. Furthermore with the Affordable Care Act, primary care is available for many and most particularly, the vulnerable population (Dill, 2013).The population is increasing and the number of the elder generation is also increasing and this affects the operation of the primary care providers. The income that the primary care providers earn is not satisfactory to the work they do. This has made many medical students refrain from primary care careers. Support from other health organization on their operations is also minimal (Bodenheimer& Pham, 2010; Friedberg et al, 2010).
Statement of need
The work life of primary care providers was challenging. The providers had an increase in workload. The number of patients the primary care provider saw was more than the money paid. The compensation for a primary care provider is approximately 55% as that of medical specialities. The cumulative lifetime net gap is approximately $3.5 million. The resource based relative value system (RBRVS) which bases scheduled payments for the Medicare fee-for-service are responsible for these results (Collins, 2012).
This has also discouraged U.S. students from choosing primary care careers. In a survey conducted in 2007, only 7% of the medical students in a fourth year class had chosen a career in primary care. Studying medicine is expensive, plus it takes seven years to complete a doctor’s degree. The amount of student loans that these students have at the end is a lot, and they would therefore choose to specialize rather than become primary care providers (Jacobson& Jazowski, 2011).
The shortages of primary care providers are in the rural areas of the United States and the population there is underserved medically. The primary care providers are unable to financially support the primary care practice and there are also lifestyle challenges and practice issues. Such places receive low pay due to the significant disincentives that the Medicaid low payment rates created (Collins, 2012; Brown 2013).
The RBRVS is biased towards acknowledging expertise skills in performing a specialized procedure as compared to professional time. They are also biased towards expertise making a diagnosis through looking at the difference in multiple potential conditions and advancing chronic conditions that are involved with cost and morbidity.
Geographical areas which record low federally defined standards due to low supply of primary care providers relative to the population are referred as Health Professional Shortage Areas (HPSA). Americans living in these areas have primary care providers’ shortages due to the poor geographical distribution of most health clinics and hospitals, for instance, Nebraska records 1.4% whereas Mississippi records 57.3% (Van Vleet &Paradise, 2015). Mayo clinic in Rochester would benefit the people in that areas since it is specialized there and primary care providers are available for the population.
The enrolling of minority students in public medical institutions has stagnated over a period of time and this could be due to race-based admission program and policies geared towards removing race based admission programs. This was evident in 1996, the Hopwood case involving Texas and California`s proposition of regulating procedures of affirmative action. There were controversies over populace equality on race and ethnicity.
The existing workforce for primary care providers does not represent the minority population. The minority population has been successful in delivering health care to underserved population in rural U.S. Post baccalaureate programs are effective in assisting pre-med students that account for the minority, in establishment of their qualifications, but these programs are not fully utilized to create a work environment with a balanced population (Lakhan&Laird, 2009).
International medical graduates present a category of practitioners that can be useful in providing primary care in rural areas since they apply for these graduate opportunities. However, they are not readily accepted in the U.S. and the US medical community. There have been efforts made to limit the acceptance and residency or international medical graduates due to competition they bring to US medical graduates and training costs (Lakhan&Laird, 2009).
There are fewer osteopathic medical schools as compared to allopathic schools. These schools have also recorded a minority individual underutilization (Lakhan&Laird, 2009). Osteopathic schools have the same principles as primary care providers and this is an o...