Healthcare analysts have pointed out that one possible negative externality of the Affordable Care Act is the law’s potential to exacerbate the existing primary care doctor shortage by expanding the pool of insured Americans and, in all likelihood, consequently increasing demand for medical services. The Association of American Medical Colleges (AAMC) estimates that the current “doc shortage” hovers at around 13,000 – a number expected to swell to more than 90,000 by the end of the decade.
There have been several encouraging signs over the past few years suggesting that medical students and colleges alike have taken initial steps to confront the daunting chasm. According to the AAMC, an all-time record number of students – 48,014 – applied to American medical colleges last year, and the aggregate 2013 freshman class at U.S. medical schools was the largest ever. That’s especially encouraging when coupled with a 2013 report by the American Academy of Family Physicians (AAFP) finding that the number of medical school graduates choosing family medicine and primary care rose for a fourth consecutive year.
To be clear, the number of students going into medicine and choosing family practice must continue growing in order to catch up to projected future demand. But there’s one major barrier to reversing the doc shortage across all specialties that could be addressed by simple congressional action: increasing federal funding for residency training programs. This funding has been capped for the past 16 years – a troubling reality given that more than 1,000 medical students were not matched with residency last year due to a dearth of available spots. The ACA does include a Primary Care Residency Expansion (PCRE)program that seeks to increase the number of residents in general internal medicine, family medicine, and general pediatrics by enhancing funding for such three-year residency programs. However, this program is only funded through 2015. Beyond that, Congress will have to pass legislation if it wants to clear this particular blockage in the medical industry pipeline.