The federal Affordable Care Act is designed to extend insurance coverage to many more Americans than are currently insured — as many as 30 million more, according to a recent report in The New York Times. But will these newly covered people be able to find doctors to treat them? Only with difficulty.
Simply put: Guaranteeing medical coverage does not also guarantee access to a doctor.
Connecticut's statistics show the problem. A quarter of the state's primary care doctors (internists, family physicians and pediatricians) are not accepting new patients, according to a 2010 survey by the Connecticut State Medical Society. And a quarter of the physicians surveyed said they might move out of state in the next five years.
The Medical Society report notes that 40 percent of Connecticut's doctors are at least 50 years old, "an age at which physicians begin to contemplate reducing their patient hours." Clearly, Connecticut needs to attract new doctors and give those already here incentives to stay and keep practicing.
A major reason some doctors are unhappy here is the state's medical malpractice environment. Rates for malpractice insurance in Connecticut are among the highest in the country, says the Medical Society. Also, many other states offer incentives for physicians to stay; Connecticut does not.
And for years, doctors have also complained that Connecticut's Medicaid reimbursement rates are so low that it costs more to see a Medicaid patient than they get paid.
The numbers of primary care physicians coming out of UConn's and Yale's medical schools are "clearly inadequate for the primary care needs of the state," says the head of the Connecticut chapter of the American College of Physicians. That's assuming the new doctors stay here after they graduate.
There is, however, progress. One goal of the state's Bioscience Initiative, unveiled last year by Gov.Dannel P. Malloy, is to attract new physicians and dentists to Connecticut. Officials hope to increase enrollment at the UConn Schools of Medicine and Dentistry by 30 percent. A loan-forgiveness program for those who remain in Connecticut is being developed.
Hamden's Quinnipiac University is building a new medical school on its North Haven campus. It's expected to enroll its first students in about a year, pending approval from the Liaison Committee on Medical Education of the Association of American Medical Colleges. Its emphasis will be on training primary care physicians, which should reduce the state's doctor crunch. Quinnipiac, too, is considering tuition reimbursement and loan forgiveness for those who stay in the state.
But more needs to be done.
A bill in the last session of the General Assembly would have allowed 10 "targeted health areas" where doctors would be eligible for loans and hiring-incentive funds and communities could get matching grants for their recruitment. The bill, which focused on medically underserved parts of the state, directed the Department of Economic and Community Development to make the funds available through its Small Business Express program. It passed the Senate unanimously, but died in the House as the session ended.
Lawmakers should resurrect the bill, which obviously enjoys wide support, when they next meet. And they should revisit malpractice lawsuit reform by protecting doctors who can prove they've followed best practices. That would lower doctors' insurance premiums, which could help keep them here.
Time is running out to have enough doctors to meet Connecticut's anticipated medical needs.Copyright © 2015, The Baltimore Sun