Becker's Hospital Review

Save the date! Becker's Hospital Review 6th Annual Meeting — May 7-9, 2015 — Chicago. Please call 800-417-2035 to register. 11 "Hospitals likely do not have the internal staff there specifically to do this kind of integration work. So it may require some handholding at least ini- tially while they get going." Overspecialization of the physician workforce and questions over the physician shortage. As an increasing number of Americans gain insurance coverage, the demand for primary care increases. It is the building block of healthcare reform. Yet not enough medical students are go- ing into primary care, instead choosing more lucrative subspecialties. Approximately $13 billion federal dollars are given to 759 medical institu- tions with residency programs, but 158 of them do not produce any primary care physicians, according to an Atlantic article from July 2013. More than 6,000 regions across the U.S. are designated Health Professional Shortage Areas for their lack of primary care, according to the U.S. Depart- ment of Health and Human Services. Each physician in a Health Professional Shortage Area sees 3,500 or more patients. Yet despite the increasing need for primary care, the health industry may still be able to fend off a full-blown crisis. Recently, there has been more conver- sation devoted to whether the physician shortage may unfold as predicted. "The outdated shortage modeling is the assumption of how much an indi- vidual physician can treat. As we look at creating a more effective care model, we have seen a substantial increase in the number of patients that a primary care physician can see because they are working in conjunction with primary care coaches," says Rob Lazerow, practice manager of research and insights at the Advisory Board Company. The shortage model may in fact be outdated — HHS shortage area modeling doesn't account for primary care provided by nurse practitioners or physi- cian assistants in their projections. "There is absolutely a move toward team-based care. In some cases it is nurse practitioners or community-based providers, [and] even paramedics are conducting in-home visits as part of their weekly shifts," says Mr. Lazerow. "Some have projected shortages there as well. It would not surprise me if supply does not keep up." If he is right, the gap in primary care physicians due to overspecialization can only be partially abated by other healthcare providers. "One way around a shortage, if you can't increase supply, is to figure out how you can restrict demand. ACO-style models are all about preventing care in the first place. That absolutely could be a strategy. The reality, though, is that it takes time to do that," says Mr. Lazerow. "It's not an overnight solution. The amount of time it takes to prevent someone from needing a surgery is a matter of years." Until medical schools are incentivized to graduate more primary care physi- cians and ACOs catch up, healthcare reform may need to depend on alternate primary care providers. Webinar Changing the game: Revolutionizing the Supply Chain for Physician Preference Items sponsored by Cardinal Health January 29th, 2015 @ 1:00pm CST To register call 800-417-2035 or email egoodman@beckershealthcare.com Visit: www.beckershospitalreview.com and click on the Webinars tab Register Today for Becker's Upcoming Complimentary Webinar: Hospital Review In the wake of consolidation, many executives are beginning to realize their health systems have yet to achieve true "systemness."

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