Oklahoma, already short doctors, could see a big increase in demand in 2014
Now that the Supreme Court’s ruled President Obama’s health care law constitutional, those in the medical community look to the 2014 deadline with concern. Oklahoma’s political leaders are largely holding off on any significant moves until after the November presidential election. Barring repeal, hundreds of thousands in the state could gain insurance coverage, whether through Medicaid, their workplace, or a so-called health care exchange. They’ll want primary care doctors, something Oklahoma is already struggling with…
Massachusetts is the only state that has dealt with an individual mandate with a penalty…
“As I recall, the predictions were the system would be overwhelmed. Primary care system would be overwhelmed and emergency departments would be overrun.”
Richard Aghababien is president of the Massachusetts Medical Society, a doctor’s group. They survey doctors every year about whether they’re taking new patients, and the waiting time for a routine appointment. And after 2007…
“The transition actually went pretty well. Physician’s offices expanded capacity and took on some patients. Also medical systems did the best they could to increase clinic opportunities. So eventually the increased capacity was absorbed.”
“Where our shortcomes are, we’re probably one of the least prepared states for health care reform. And we know one of those reasons to be a shortage of physicians.”
To just get to average in the US, Oklahoma needs about 2-thousand more doctors in primary care. Again, that’s just to hit the average mark in the country. Across Tulsa at the OU Family Medical Center, I meet Dr. Russell Kohl. He isn’t convinced 2014 will mean much of a change. The new patients could be served with another hundred doctors…
“So in the grand scheme of things, when you’re already down by 2-thousand, to say that an extra one hundred is going to just completely overwhelm the system is kinda a hard argument to make.”
Okay so Oklahoma doesn’t need to become Massachusetts in a matter of 17 months – even if it wanted to, it takes 7 years from the start of med school to become a practicing doctor. But what can the state do to make sure those people with insurance can at least get the coverage they’re provided?
“Kaiser is doing oh, almost 40 percent of its visits by e visits or telephone, up from virtually nothing only three or four years ago, which is a huge savings in time and productivity.”
That’s Jon Kingsdale, an expert on the topic. He set up Massachusetts’s Health Care Exchange, known as the Connector, and ran it for four years. Community health centers also became a bigger part of that state’s health care system, something that Richard Aghababien, again from the Massachusetts doctor’s group, hopes spreads down here…
“Whether it’s hospital based or private practice based, would go out and make the investment in creating clinics where patients could be seen by physicians.”
Dr. Kohl says the focus can’t simply turn to physicians. There’s physician assistants, nurses, and other medical professionals out there…
“Finding the right care at the right time for the right person is the trick, not how do we get this person to see a doctor.”
Important to remember, many of these patients were already getting care, most likely in the emergency room. If the law goes into effect in 2014, they’ll want a dedicated primary care doctor, or something similar. Again, Dr. Shrumm, at OSU.
“The health care problems that we have today are going to be not just considered an underserved area or a problem in rural Oklahoma, but it’ll be considered in the Capitol and the other larger cities across the state.”
Residencies are getting created in Oklahoma…Governor Fallin signed into law a bill authorizing 3 million dollars this year, split between OU and OSU. But again, it’s going to take time.
Everyone agreed on one point: the health care law could spur even more change, simply out of necessity.
“Even if we were to increase medical school sizes and we geared up and we had our residency program, we are not going to be prepared for 2014.”
January could bring President Romney to the White House, and a repeal could render this discussion meaningless. But without that, it appears a doctor’s appointment may be a little harder to come by in 2014.