The Patient Protection and Affordable Care Act promises to provide solid solutions to the physician shortage crisis in America. With the influx of millions of people gaining access to healthcare insurance, and the decrease in the enrollment of medical students, the doctor shortage in America may reach approximately 150,000 in the next 15 years. According to the Association of American Medical Colleges, the people most under served by medical care are those who live in the rural communities in the United States. People in these areas have higher rates of chronic disease, poor preventative care access and limited technology and communications.
A Unique Economy
Rural economies have evolved from the loss of manufacturing jobs into a high percentage of self –employment in small businesses, agricultural and services. Unlike urban areas that have strong health insurance-supported corporations, rural areas are more likely to rely on currently underfunded Medicaid and child assistance programs. Conversely, people in these parts of the country may not have the opportunity to use their insurance due to the absence of available healthcare providers.
Special Health Problems in Rural Areas
People who live in farming communities may encounter toxic chemicals that result in a high population of cancer clusters. Generally, the rural populations are older and experience higher chronic illness such as arthritis, diabetes and mental health issues. Since access to care is limited, many elderly do not receive the assistance with activities of daily living. The physician shortage endangers people who must travel one hundred miles or more to acquire care in medical emergencies.
Proposed Innovations in the Healthcare Force
A large portion of physicians are from affluent families that provide the steep costs of medical school. New graduates may begin their careers in debt from school loans in excess of $300,000 or more. Beginning a medical practice in a lower paying rural area and recovering their loan costs is simply not feasible for physicians.
Healthcare reform intends to change the prohibitive costs of medical school by providing the best and brightest with scholarships and loan repayments. Doctors and nurses who choose to practice in rural areas will be provided with incentives and tuition reimbursement programs that will help recover school loan debt.
In addition, healthcare reform may widen the responsibilities on the scope of practice for non-physician healthcare providers. Nurses, nurse practitioners and physician assistants may become the first line of primary care; leaving physicians to provide medical care for more complex cases. Healthcare providers may use a standardized formulary to prescribe common medications, treatments and order laboratory tests.
Removing Technological Barriers to Care
Rural communities typically lack the infrastructure to support computerized communications with large hospitals and specialty health services. The Affordable Healthcare Act allocates funds to expand current telecommunications that will allow physicians in rural areas to access tele-health for specialty care services for patients. Patients in remote areas will have electronic access to radiologists, neurologists, urologists and other medical specialists. Because tele-health is easier on those who are administering care, we can expect to see a rise in registrations for online RN-BSN programs.
Health Reform Ideology
New health reform plans to increase the amount of healthcare professionals in rural areas and access to healthcare. In addition to providing incentives, scholarships and tuition reimbursement to medical students, the healthcare law also offers Medicare payment incentives and loan repayments to existing physicians. Health reform may expound on healthcare providers scope of practice and change the way healthcare is delivered.