Apr 072016
 

HEALTH April 2016 Senior Wire News Service

A Healthy Age

By Amy Abbott

 What are some of the ways the healthcare system is addressing these shortages and how can you get the care you need? It’s a mishmash, but here are four approaches: telemedicine, retail clinics and urgent care centers, mid-level providers, and delayed retirement.

Whether your aching knee needs an orthopod or your grim outlook needs a psychiatrist, we seniors are finding it nearly impossible to see specialists on a timely basis. And since we’re one of the biggest users of health care, it’s a problem.

A major study released by the Association of American Medical Colleges examined the physician shortage and projected how it will evolve through 2025.

  • Physician supply will increase, but demand will outpace supply.
  • The Affordable Care Act will add up to 2 percent demand.
  • In 2025, the demand for physicians will outpace supply by a range of 46,000 to 90,000.
  • The shortages will, however, vary by specialty. For example, there may be a shortage of between 12,500 and 31,000 primary care physicians. Specialists are worse. The shortfall may be between 28, 200 and 63,700 non-primary care physicians.

The study noted that because physician training can take up to a decade, a shortage in 2025 needs to be addressed now.

What are some of the ways the healthcare system is addressing these shortages and how can you get the care you need? It’s a mishmash, but here are four approaches: telemedicine, retail clinics and urgent care centers, mid-level providers, and delayed retirement.

  • Telemedicine. Telemedicine may be the new buzzword in health care. Originally started in rural areas, the Chicago Tribune reported in February 2016 about 800,000 remote visits happened in urban areas this year. Patients like the idea of not traveling to another city for care; physicians like the idea of a reduced overhead and more time with patients.Some physicians add telemedicine to their practice while others solely practice telemedicine. If you are still employed you may have access to a medical professional for low-level problems via a telephone system as part of your employer-provided health insurance program. The Tribune also noted that state parity laws require coverage for telemedicine via private insurers that are comparable to office visits. The number of states with parity laws has tripled recently.
  • Retail Clinics and Urgent Care Centers. You can’t throw a rock without hitting one of the new retail clinics. They are popping up in every corner drug store and Big Box retailer. Urgent care clinics have been part of the landscape for some time now. Seniors who don’t like waiting in an office may enjoy the convenience of getting a flu shot before buying the weekly groceries.The Convenient Care Association reported more than 20 million patients were served by retail clinics. The Chicago Tribune noted 1,800 retail clinics in 40 states and the District of Columbia – and the numbers keep growing. Retail clinics offer basic care, from flu shots to urinary tract infections and bronchitis. Retail clinics are not for serious health conditions.Nearly 10,000 urgent care centers are available throughout the states. These centers initially opened to offset the crowding and wait times of emergency rooms. You will generally find a physician on staff at each center, unlike the retail clinics which may use mid-level providers.
  • Mid-level providers. You’ll find mid-level providers at nearly every level of care.
    Advanced nurse practitioners have a degree beyond the registered nurse, and physicians assistants have 26 months of medical training, and 2,000 hours of supervised clinical practice.Nurse practitioners can operate an independent practice while physicians assistants must do so under the supervision of a doctor. Nurse practitioners have been around for half a century, but today take on a greater role in providing care. They can practice independently in 19 states and the District of Columbia.
  • Delayed retirement. While some articles suggest that physicians are delaying retirement due to the doctor shortage, I could find no significant evidence of this. In the last five or six years, many physicians delayed retirement due to the recession but didn’t claim it as related to any shortage.What I did find documented is that baby boomers want to work longer, and medical organizations are accommodating them in new ways which is having the same effect on delaying retirement. However, providers are moving to part-time or flex-time positions, many are taking on telemedicine responsibilities, or doing “shift” work in an emergency room or as a locum tenens. Roughly translated from the Latin, locum tenens means “to hold a place” and describes a type of physician who works on a temporary basis in a hospital, practice, or clinic.

The bottom line: The patchwork quilt of our healthcare system is a work in progress.  We have to control those health conditions we can control. The best use of the system is staying healthy and out of the system.

Where Have All the Doctors Gone?