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Got health insurance? Good luck finding a doctor

Matin Bahadori | Photolibrary | Getty Images

Thanks to the Affordable Care Act, 31 million previously uninsured Americans are about to gain access to health coverage.

But who's going to treat them?

The Association of American Medical Colleges estimates a shortfall of 63,000 doctors by 2015and one of 130,000 doctors by 2025. U.S. medical schools would have to graduate seven times more doctors that year alone just to keep pace.

We need more doctors in America, and we especially need more of the small, primary care practices that often represent the only health care available in underserved areas. Unfortunately, market dynamics and policy changes are turning the independent family doctor into an endangered species.

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But emerging technology could be coming to our health-care system's rescue. New applications promise to boost efficiency, drive down operating costs, and make the small practice practical for American physicians.

Just as Square has lowered the barrier to entry for small businesses by enabling them to accept credit cards, innovative tools can fundamentally alter the incentives facing doctorsand perhaps save the small, family practice model just when it's needed most.

The private, independent practice has been on a steady decline for some time. Only 8 percent of medical school graduates go into primary care and only 1 percent of residents in one recent survey said they wanted to open a solo practice.

As a result, in 2011, 30 percent of Americans looking for new primary care doctors had a problem finding oneand these were people with private insurance.

What is driving doctors away from the independent practice? It's just businessspecifically, the difficulty of running a small business in addition to doing the actual work of providing care.

In fact, an overwhelming majority of the doctors in the Accenture survey (87 percent) cited the difficultyand the costof running a business as a top concern, while on the flip side, a recent McKinsey study found that doctors, all things being equal, would prefer to be on their own.

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For those living in remote areas and other underserved communities, this has a real effect on their health and access to care since the small, private practice is often the best, or even only, way to get basic care. Rural areas are home to nearly a quarter of the American populationbut only 10 percent of American doctors.

For the rest of the country, a dearth of primary care physicians means more people using expensive ER care and forgoing the prevention needed to keep them healthytwo problems health reform was designed to fix.

But the private practice isn't necessarily doomed. After all, just as technology has helped small businesses lower barriers to entry, reduce overhead costs, and compete with companies of all sizes, it can do the same for the small businesses we call family doctors.

For instance, physicians estimate that 12 percent of appointments go unfilled, leading to a 14 percent decline in total clinical income. Moreover, the doctor's staff must devote valuable time to answering phones, booking appointments, and following up with patients.

According to a 2011 Intuit Health study, one-third of health-care providers said that their staff spends three hours or more each day trying to reach patients just for follow-up.

With online and mobile applications in which patients can see and book a physician's available appointments, doctors can adjust their office hours anytime to meet latent demand. In turn, this enables them to maximize their productivity and, in turn, provides doctors the kind of flexibility usually only found in a larger practice.

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Emerging online marketplaces for medical care—where price and quality are transparent—stand to reduce barriers to entry and help new doctors quickly build a client base and get their practices up and running. New software can streamline billing and provide the data doctors need to effectively negotiate with insurers for better rates. Advances in telemedicine can offer alternative, more inexpensive ways for physicians and patients to interact.

And with the transition to electronic medical records, doctors can more easily keep track of medical histories and courses of treatment, reduce errors, and access all that information remotely if need be.

For the independent practice, these advances in technology mean easier administration, improved flexibility, better quality of care—and, ultimately, a viable and profitable business model. It means caring for patients more while spending less time and resources on the administrative paper-shuffling that drives too many providers away from private practice.

And it means making it easier for doctors to be doctors, and deliver the care the country—and the newly insured—will need in the years to come.

—By Oliver Kharraz, M.D., ZocDoc founder and COO

Technology