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28 Clinical Integration & ACOs F or years, the medical community has largely agreed the United States is facing a critical physician shortage that will seriously impact patients' ability to get medical care in the very near future. In the face of the baby boomer generation reaching and surpassing the age of retirement combined with millions more previously uninsured peo- ple getting coverage, this prediction seems logical. Yet many healthcare experts have denounced such claims, further arguing that efforts aimed to combat a shortage that won't actually happen could impose further stress on the national healthcare system. Confronted with recent debates on the validity of projected physician def- icits, those who maintain that the shortage is a true threat to the nation's healthcare system often express the opinion that it's wise to train and intro- duce more physicians to the workforce just in case. Healthcare experts argu- ing against claims of the shortage take a very different point of view. For example, Gail Wilensky, PhD, senior fellow at Project HOPE and co-chair of the Institute of Medicine panel, describes this attitude as wasteful. Accord- ing to Kaiser Health News, she said, "You're talking about somebody who is potentially 12 to 15 years post high school, to invest in a skill set that we're not sure we're going to need?" The issue, many experts agree, is that physician shortages cannot be summed up as a national experience. Rather, shortages are a regional issue, and must be solved with regional solutions. Predictions of an impending physician shortage are founded on two factors According to the Association of American Medical Colleges, the U.S. will face a shortage upwards of 130,600 physicians by 2025. Two main factors have guided this belief. One is that the population of people over age 65 will increase to 19 percent of the total U.S. population by 2030, up from 12.9 percent of the population in 2009, the latest year for which data is available, according to the U.S. Department of Health and Human Services. The second main factor is the Patient Protection and Affordable Care Act. According to the Commonwealth Fund, an estimated 20 million Americans have gained coverage under the PPACA as of May 1, 2014, many of whom were previously uninsured. Future projections show the number of insured Americans will reach 26 million by 2017. Based on this data, forecasters pre- dict the rapidly increasing rate of Americans gaining coverage will mean more people seeking medical care. Furthermore, those who were previously uninsured are likely in poor health. According to the Kaiser Family Foundation, nearly a third of un- insured adults in 2014 forewent needed medical care due to cost, and studies have consistently demonstrated that the uninsured are less likely to receive preventive care and treatment for major health and chronic conditions compared with insured people. Given these facts, many of the newly insured will likely seek care for complex conditions that require high-cost treatments. What if We Were Wrong About The Physician Shortage? By Tamara Rosin