The Association of American Medical Colleges predicts that by 2025 there will be an estimated shortage of 12,000 to 31,000 primary care physicians. One of the main issues fueling this shortage is the aging physician workforce from the baby boom generation that is preparing to retire, meanwhile an estimated 30 million Americans have purchased insurance since 2010 through the Affordable Care Act. The following are six alternatives to help address care shortages and to lower costs:
1. Retail Clinics—These are generally found in pharmacies, groceries and “big box” stores. According to the Convenient Care Association, the walk-in clinics started in 2000 and cared for more than 20 million patients in 2014. Visits cost anywhere from $40 to $75 and can address acute conditions (i.e. bronchitis and ear infections), administer immunizations, and provide physicals. Usually the clinics are able to accept health insurance and can send records of your visit to your primary care physician. However, retail clinics are only able to treat a limited list of problems.
2. Urgent Care Centers—These same-day walk-in clinics focus primarily on emergency medicine for acute (but less severe) medical problems. They eliminate some of the frustration that arises from long waits in emergency rooms and for appointments with physicians. Urgent-care centers are staffed by trained and licenses physicians, medical assistants, registered nurses, and X-ray technicians, and more than 1/3rd of them are hospital owned and operated. Up to 27% of emergency room visits could be handled at retail clinics and urgent-care centers, which could save up to $4.4 billion per year.
3. Nurse- Led Practices—Advanced- practice registered nurses (APRNs) are nationally certified registered nurses who have completed a master’s or doctoral program, and have advanced clinical training in primary care. Nurse practitioners, a subgroup of APRNs, are able to practice independently in 19 states and can diagnose/ treat conditions such as diabetes, high blood pressure, infections, and injuries.
4. Team- Based Care—Nurses, doctors and other providers are working together so that patients can receive comprehensive care. The average length of a health care visit is less than 15 minutes, which is not enough time to address all of the patient’s needs.
5. Physician Assistants—They emerged in the mid-1960s when there was a shortage of primary-care physicians, and their training was based on the accelerated training that doctors received during World War II. Physician Assistants do not practice independently like nurse practitioners, but they still under go 26 months of medical training and 2,000 hours of supervised clinical practice. Their duties usually include performing physicals, ordering/interpreting tests, developing treatment plans, prescribing medication, and assisting in surgery. The Bureau of Labor Statistics estimates that the number of physician assistant jobs will increase by 39% between 2008 and 2018.
6. Telemedicine—Patients want to take advantage of advances in mobile technology, and this motivation may have the potential to change traditional face-to-face visits.
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