So Many New Patients; Are There Enough Doctors?

The new health care law will provide health insurance for 32 million Americans who don't have insurance now. That means more people will be turning to America's doctors and nurses for care. But will there be enough of them to go around? Host Liane Hansen speaks with Dr. Atul Grover, chief advocacy officer for the Association of American Medical Colleges, about what the new health care law will mean for doctors and patients.

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LIANE HANSEN, host:

The new health care law will provide health insurance for 32 million Americans who don't have insurance now. That means more people will be turning to America's doctors and nurses for care. But will there be enough to go around?

Dr. Atul Grover is the chief advocacy officer for the Association of American Medical Colleges, a group that represents medical schools and teaching hospitals. He joins us from St. Louis Public Radio in Missouri.

Welcome to the program, or I should say welcome back.

Dr. ATUL GROVER (Chief Advocacy Officer, Association of American Medical Colleges): Thank you very much for having me again, Liane.

HANSEN: All right. Well, we had talked about his idea of having enough doctors and nurses. And now that the bill has passed, are there enough doctors and nurses in America to take care of all the people who will be covered?

Dr. GROVER: Well, I think that because the coverage is going to be phased in over the next couple of years, we have a little bit of time before we have this great onslaught of new patients to take care of. And remember, our teaching hospitals are safety net institutions that are very often taking care of these uninsured patients right now already whey they get very, very sick.

So I think we'll be okay for a few years. But it means we really have to start immediately in trying to get the number of physicians, nurses, other health professionals trained up to an adequate point.

HANSEN: What do you think can be done to attract more physicians into primary care?

Dr. GROVER: I think this bill is a good first step in attracting more physicians into primary care. When you have a playing field in medicine where some doctors are making two or three times as much what the average primary care physician makes, that certainly makes primary care less attractive. So I think some of the primary care bonuses, the Medicaid payment floors that are in this legislation will help.

HANSEN: The new law includes something called Health Care Innovation Zones. What are they and how will they help patients?

Dr. GROVER: What the concept is, is this: in the current payment system we are largely paid on volume and not for outcomes. So what the innovation zones would do is give us some of the regulatory and financial freedom to try and discover better ways of caring for communities that are really removed from the crazy incentive payment system that we have right now.

HANSEN: Can you give us an example of how that would work?

Dr. GROVER: Sure. So let's we've got very, very high cost patients in the Medicare program with four or five chronic conditions. They have to be seen by five, six specialists, primary care physicians. And a lot of their conditions may require more care at home.

So if I have the ability to be paid to take care of a patient not on the basis of how many times they come into my office or how much they're in the hospital, but rather to really take care of them based on their outcomes, then I can focus on doing what is best for the patient without worrying about the financial bottom-line.

Right now that is very difficult to do because unless we have a face-to-face visit, in most cases, we dont get paid for taking care of people. And thats just not the right set of incentives to transform the delivery system.

HANSEN: Dr. Atul Grover is the chief advocacy officer for the Association of American Medical Colleges. He joined us from St. Louis Public Radio. Thanks a lot.

Dr. GROVER: Thank you, Liane.

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