Doctor shortage in California will blunt health reform's effect

In an article pulled from the San Jose Mercury News (.com), Steve Jacob warns that the new health reform law, which is planning to create more insured Americans, will not mean much to patients without providers to care for them.  Nurse Practitioners, Physicians’ Assistants, R.N’s, CNM’s and other Allied health Providers will work to make up the gap between the providers and the patients. If there is no affordable medical malpractice insurance for these allied healthcare providers, then the increased patients will still not receive the care that they need.

Our Insurance Agency in Northern California continues to work hard to develop affordable premium discounts and insurance programs for Nurse Practitioners, Colon Hydrotherapists, Physician Assistants and other care providers.

.  Nurse Practitioners, pay between $ 1,000 and $ 2,500 for Occurrence Coverage, which means that they are free to cancel and move on to another career opportunity, Physician Assistants will need to consider whether they want the affordable occurrence policies, or claims made (which are less expensive to begin with and increase over time, billing the expensive tail premiums upon cancellation.

The federal government plans to expand Medicaid to low-income adults and subsidize purchases on the health insurance exchanges when it requires most California will have more than 3.6 million more insured residents because of reform, according to an Urban Institute analysis. 

The Doctors’ Insurance Agency is putting together Alternative Risk Methodologies, working with the underwriting department of The Doctors’ Company to help resourceful medical groups find ways to attract doctors to their networks.  There are ACO’s, PHO’s, IPA’s, all forms of Integrated Delivery Systems, which can bring economies of premium discounts to their individual member physicians.  If the physicians share a bond at a hospital or an Independent Physician Association, a Surgery Center or Medical Foundation, we can help them save up to 40 % on their premium for medical malpractice insurance while still providing the necessary entity limit protecting the business risk of signing contracts with medical payers, hospitals, and hiring and credentialing physicians.  This risk is commonly referred to as Directors and Officers Liability and Managed Care Organization Liability Insurance.   It is important to protect the physicians and lay persons who are sitting on your boards from the risk of their individual assets exposed to business decisions that they make on behalf of the medical entity. 

Managed Care Organization Insurance, Allied Health Care Professional Liability and Medical Facility Liability Insurance can all protect the physician’s individual medical malpractice insurance policy from being named in a claim.

Primary Care Physicians especially should work with Allied Health Care Providers to protect their policy limits.  A primary care physician is the first contact for people with undiagnosed illnesses. They include family physicians, pediatricians and internal medicine doctors. Primary care physicians' share of the U.S. health care dollar is only 7 cents. However, primary care doctors control 80 cents of the health care dollar by sending their patients to hospitals, referring them to specialists and prescribing medications.

The United States has about the same number of physicians per capita as other industrialized nations. However, the United States has far fewer primary care physicians than specialists. They make up about 50 percent of the physician workforce in most other developed nations, compared with 35 percent in the United States.  Allied Health Providers are going to have to make up the difference and help fill this gap, as more physicians gravitate to specialties and the need for primary care increases.

So too will primary care, affordable, accessible health care models (like going to a Walmart Health Clinic to be serviced by a Nurse Practitioner, Registered Nurse or other Medial Licensed personnel.  The Doctors’ Insurance Agency can provide the healthcare provider that will extend and expand the primary care provider’s practice with the insurance necessary to make this happen.

As the baby boomers need for primary care, foot care, and everyday monitoring of health increases, The primary care workload is expected to increase…some say up to 30 percent in the next 20 years.  A number of factors feed this demand, including a growing population, a flood of baby boomers becoming Medicare beneficiaries and acquiring medical conditions as they age, and the newly insured because of the reform law.

However, the supply of primary care physicians is expected to rise by only 2 to 7 percent. Three out of 4 physicians say they already are at or over capacity. The math screams that there will be a crisis of health care access in the next 15 years.

Expect longer waits for appointments, shorter physician visits, greater use of non physicians for routine care and higher prices.

The U.S. trains about 16,000 doctors a year. The nation would have to increase that number by 6,000 to 8,000 annually for 20 years to meet expected demand.

Adding to the sense of urgency is the fact that nearly 1 in 3 California physicians is 60 or older.

The only way to continue to meet this demand is to embrace the less conventional idea of helping a primary care provider meet the needs of this increasing load of patients, while using the Allied Health Community.  The Doctors’ Insurance Agency will continue to look for affordable programs to insure these professionals.

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