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 2015—and 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 doctors—and 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 one—and these were people with private insurance.
What is driving doctors away from the independent practice? It's just business—specifically, 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 difficulty—and the cost—of 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 population—but 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 healthy—two problems health reform was designed to fix.