California Faces Headwinds in Easing Doctor Shortages

By David Westphal, CHCF Center for Health Reporting

The Supreme Court’s validation of President Obama’s landmark health law sets off a scramble across California to find enough primary care doctors and other professionals to serve an estimated 3 million newly insured patients by 2014.

California already rates below average in the number of doctors per capita.  But the state – rural counties in particular – will face additional headwinds as health reform slashes the ranks of its 7 million uninsured.

California has an unusually large number of doctors heading into their retirement years.  It expects a much higher-than-average rise in the health-intensive 65-and-older population.  And it has one of the lowest reimbursement rates in the country for Medi-Cal, the state’s primary program offering health coverage for the poor.

Especially for communities that are already struggling with doctor shortages, the court’s somewhat unexpected endorsement of the Affordable Care Act suddenly presents a steep challenge.

“What good is it in 2014,” when millions of uninsured Californians will gain coverage “when they don’t have access to providers?”

“The Affordable Care Act will add hundreds of thousands of people to the rolls of the insured.  That’s good,” said Dr. G. Richard Olds, founding dean of the UC Riverside School of Medicine.  “But where are the primary care physicians going to come from to serve that population?”

According to a 2009 study by the California HealthCare Foundation, only 16 of 58 California counties had sufficient primary care doctors as measured against standards set by the American Medical Association.  The Association of American Medical Colleges has warned the nation could reach a shortfall of nearly 100,000 doctors by 2020. Continue reading