Newly insured will be met with shortage of care providers
By Luis Fábregas
Published: Sunday, Sept. 29, 2013, 11:39 p.m.
As Pennsylvanians begin to shop on Tuesday for government-subsidized insurance, health care providers question whether they can accommodate the anticipated influx of patients.
“We're going to be inundated with patients,” said Dr. Jeannette South-Paul, a family doctor at UPMC's Matilda Theiss Health Center in Oakland and chair of the department of family medicine at the University of Pittsburgh School of Medicine. “There really aren't enough of us (doctors).”
More than 200,000 uninsured people live in Western Pennsylvania, an estimated three-quarters of them adults in Allegheny County alone, industry experts say.
The newly insured will head to doctors' offices and hospitals at a time when Pennsylvania's physician workforce of about 32,000 cannot meet existing demand. Most counties, especially those in rural areas, report shortages of doctors, according to the Pennsylvania Medical Society.
“We won't have the providers to meet the demands,” said Dr. William Minor, director of a Morgantown, W.Va.-based family residency program that is training four physician residents at Cornerstone Care Mt. Morris Health Center in Greene County. “If a person trains in a rural setting, they're more likely to stay here.”
Predicting how quickly new patients might seek care is impossible, said Dr. Richard Schott, a suburban Philadelphia cardiologist and president of the state medical society.
The sign-up period that begins Tuesday for health insurance in online marketplaces runs for six months, though government officials hope many people will enroll by Dec. 15. Coverage begins in 2014.
Last week, Oregon, Colorado and the District of Columbia said their online exchanges — among 51 set up — experienced information technology problems that could affect some functions and lead to a slow start.
“It's very unlikely that 30 million people are going to instantly appear on the doorsteps of physicians across the country as of Jan. 1,” Schott said. “Historically, people in this country and in this state have had access to care. It's an exaggeration to say these people haven't had care or haven't had access to care.”
The potential onslaught of patients prompted health care workers such as nurse practitioners to seek more independence. State Sen. Pat Vance, R-York, this year introduced a bill that would let nurse practitioners practice independently of doctors in some clinical settings.
“We think that's not safe,” Schott said. “There's a vast difference in training. There's a concern about the liability and delay to getting patients to appropriate care.”
Most physicians instead support a team approach to delivering care, much in the way it's done at Matilda Theiss Health Center in Oakland. Health care professionals there treat patients with a mix of insurance coverage. A third of the patients are uninsured.
Under a model known as the patient-centered medical home, a primary care doctor manages a patient's care but patients can consult pharmacists, nurses, social workers and other medical specialists under the doctor's direction.
“Physicians must be in the mix,” South-Paul said. She pointed to research showing that patients in areas with a higher number of primary care doctors tend to have better outcomes, and fewer die.
The region's hospitals are trying to recruit primary care doctors. At UPMC, the largest health care provider with 20 hospitals and 400 outpatient sites, officials recently hired 20 primary care doctors and expect to hire about 30 next year from Pitt's School of Medicine.
“We are adding primary care doctors as quickly as we can,” said Dr. Steven Shapiro, UPMC's chief medical and scientific officer.
Very sick patients come to hospitals with or without insurance, Shapiro said.
“I'm not sure we're expecting too much of a difference in admissions,” he said. “We've got many extra hospital beds in this town.”
Luis Fábregas is a Trib Total Media staff writer. Reach him at 412-320-7998 or email@example.com.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Trib’s Hiel honored for reporting on Coptic Christians
- Western Psychiatric clinic rampage victim’s parents seek answers, lawyer says
- Newsmaker: Jack Goodrich
- Donor name to be stripped from Penn Hills library
- Web of surveillance videos helps ensnare suspect in East Liberty slayings
- Newsmaker: Ciara Scanlon Crossey
- Newsmaker: Joseph Bonadio
- Newsmaker: Charlotte Lott
- Pittsburgh Mayor Peduto set to meet with UPMC chief
- Qualifications of Peduto nominee for building inspection chief come up short
- Suspect in East Liberty slayings may be part of murder-for-hire case