Physician Capacity

By Greg Scandlen,

A little while ago Scott Gottleib and Zeke Emmanuel co-authored an op-ed in The New York Times pooh-poohing the concern about physician shortages.

So certain are they that conventional wisdom is wrong that the piece is headlined, “No, There Won’t be a Doctor Shortage.” Right, and “if you like your health plan, you can keep your health plan — period”. Somehow such bold assertions have lost a bit of their luster over the past few months.

Now, they acknowledge that an aging population and the prospect of 30 million newly insured people may make it seem like there might be a problem, and the Association of American Medical Colleges says their members aren’t able to train enough physicians to fill the need, but what do they know about physician supply? Gottleib and Emmanuel know better.

As Exhibit 1, they look at Massachusetts. They write –

• Take Massachusetts, where ObamaCare-style reforms were implemented beginning in 2006, adding nearly 400,000 people to the insurance rolls. Appointment wait times for family physicians, internists, pediatricians, obstetricians and gynecologists, and even specialists like cardiologists, have bounced around since but have not appreciably increased overall, according to a Massachusetts Medical Society survey.

That is a wild mischaracterization of the Medical Society’s research.

The press release about the 2013 survey quotes Dr. Ronald Dunlop, president of the group, as saying –

• Our latest survey once again points out a critical characteristic of health care in the Commonwealth. While we’ve achieved success in securing insurance coverage for nearly all of our residents, coverage doesn’t guarantee access to care. The concern is that limited and delayed access can lead to undesirable results, as people will seek more costly care at emergency rooms, delay care too long, or not seek care at all.

He doesn’t sound as complacent as Gottleib and Emmanuel. The release goes on to say −

• The 2013 study shows wait times for new patient appointments with primary care physicians remain long in the Commonwealth, with the average time to see a family medicine physician at 39 days (down from 45 days in 2012) and the average wait time to see an internal medicine physician at 50 days (up from 44 days in 2012).

Of course looking at Massachusetts in a vacuum doesn’t tell us much. … people have to wait two to three times as long to see a specialist in Boston than in other urban centers. So, again, while Boston has far and away the highest concentrations of practicing physicians, it also has the longest waiting times to see one — at least double that of any other city.

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