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Monday, April 22, 2013

Will Illinois Have Enough Family Physicians Beyond 2014?

Do we have enough physicians to care for newly insured patients seeking care starting Jan. 1? Some will be covered by Medicaid; some gain coverage through the insurance marketplace; and others turning 65 join the ranks of Medicare. The Illinois Academy of Family Physicians believes that we are ready for 2014 – but are not prepared for future demand for primary care.

Illinois currently has the capacity to care for more than 5.3 million Medicaid patients, with more than 5,000 primary-care providers participating in team-based medical homes. When patients have a regular primary-care physician, they get the care they need to avoid costly emergency room visits and hospitalizations. Connecting new Medicaid patients with a family physician ensures they get the right care at the right time in the community setting, at a much lower cost. Otherwise uncontrolled chronic illnesses can develop into costly – and preventable – hospitalizations, which drives up medical costs for everyone.

Illinois has 11 medical school campuses. This year, only 9 percent of 1,089 doctors graduating from those medical colleges chose family medicine, according to IAFP data. And only one-third of that 9 percent — 35 people — will do their residency training in Illinois; the rest will leave for other states. Family physicians are the only physicians trained to care for all ages, both male and female.

Illinois should worry about the future of our state's primary-care physician workforce. Simply stated, too many physicians trained here choose to work in other states, and Illinois is not training enough primary-care physicians.

A NATIONAL PROBLEM, TOO

According to the American Association of Medical Colleges workforce data book, Illinois ranks 20th in the nation with 95 primary care physicians per 100,000 residents. As a nation, we are facing a staggering shortage of primary care physicians. So being in the middle of the pack should not be interpreted as a positive sign.

A 2010 study led by family physician Russell Robertson (now dean of Chicago Medical School) examined new physicians' plans for practice and the reasons for their choices. Almost one-half of graduating Illinois residents and fellows leave the state to practice elsewhere. While the primary reason for do so is for family, the medical liability climate is a major consideration for those who leave Illinois to practice.

How can we turn the tide? Medical schools need admission policies favoring students willing to practice in Illinois. We also must address medical school debt that keeps many from entering primary care. Those physicians should get loan repayment or loan forgiveness incentives to practice in areas in need of primary-care physicians. As well, the income gap between primary-care and specialty physicians must be narrowed. Medicare and Medicaid must take the lead and pay primary-care physicians in accordance with the quality care and coordination services they provide, and private insurers must support primary care.

Making primary-care practice a priority ensures that every Illinoisan entering the health care system has a medical home to care for them. A future without enough family physicians will leave patients without a medical home and on the doorsteps of emergency rooms instead.

Dr. Carrie E. Nelson is president of the Illinois Academy of Family Physicians, based in Lisle.
This article was first published in Crain's Chicago Business

14 comments:

  1. Nice Post............

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  2. I would like to know what the plan is to provide any type of dental care for Medicaid patients. I know two the had simple extractions turn into prolonged hospital stays with abscesses because they didn't have coverage for dentures. I fear I'm on the same path due to prolonged prescribed opiate use.

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  3. I am an experienced Family Physician and my husband and family have moved to Chicago on business. I am Australian and UK trained and 'board certified' in Australia, UK and ireland, yet I am/have been flying back to Ireland in chunks of months to work as an FP because I am unable to practice in Illinois because of 'barriers' to overseas doctors.
    I suggest that some barriers are artificial, particularly blocking doctors from countries where FP is more widely accepted and a highly valued role for medical graduates.
    I would dearly love to practice in Illinois, but have been told that there would have to be a law change.
    Perhaps relaxing the legislation, would not only allow workforce mobility, but also bring into the US some of the sense of pride that FPs in other developed countries have about their role.

    ReplyDelete
  4. This is exactly the problem we are facing now in IL trying to find doctors who accept the medicaid card. I work with Seniors who are having a hard time finding a physician who will accept their Medicaid card. Starting October 1st, IL estimates to enroll 1.5 million uninsured people thru the medicaid expansion program and it will impossible to find doctors who will see these newly enrolled patients. What is the State doing to reachout to these Physicians and encourage them to join the network of Medicaid doctors? Are they being told their reimbursements rates will be same as Medicare rates?

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