Primary Care Shortage Undermines the Health of Everyone in the U.S.

As the presidential campaign debate over health care intensified, I heard from seven different friends with the same problem: They had loved ones who had recently moved and, like many others across the U.S., could not find a primary care doctor. Three were in Washington where, according to 2006 data from the Department of Health, 38 of 39 counties report primary care shortages.

Their plight reminded me the candidates' proposals to expand health coverage are not enough. Americans also need better access to high-quality care that the nation can afford. Unless patients can get in to see the family physicians, internal medicine doctors and pediatricians who provide that first level of contact to the system, we can't achieve the reforms needed in quality, safety and cost.

An example of potential problems ahead is seen in Massachusetts, which recently instituted universal coverage by way of a new state law requiring residents to have health insurance. Officials originally estimated that 150,000 newly insured people would be seeking care, but the number turned out to be more than 350,000. Now, The New York Times reports that the state's primary care doctors don't have capacity to manage the demand.

Such gaps in health care service loom large just as experts warn of provider shortages. "Primary care, the backbone of the nation's health care system, is at grave risk of collapse," according to a recent report from the American College of Physicians, the group that represents 125,000 internists.

At the same time, our nation's population is aging fast and will increasingly require the kind of care that primary care doctors do best: preventing illness and managing chronic conditions. ACP predicts that the country will need 40 percent more primary care doctors by 2020.

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