Physician Shortage Affecting Access to Health Care, CMA’s Staggers Says
It is becoming "more and more difficult" for California residents to get the health care they need, in part because the "number of doctors has not kept pace with the population boom," California Medical Association President Frank Staggers writes in a Sacramento Bee op-ed. Staggers says the "simple" underlying cause for the physician shortage is that "[p]ublic and private insurers are underfunding medical care." Medi-Cal reimbursement rates are the lowest among the 50 states' Medicaid programs, according to the Kaiser Family Foundation. In addition, Staggers notes that medical groups "are going bankrupt or becoming insolvent at unprecedented rates." While a recent University of California-San Francisco study, which found little evidenc of a physician shortage, "suggested trends are far rosier," Staggers says that the study "doesn't match the real experiences of California's physicians and patients and is contradicted by other data." The UCSF study calculated that California had 190 physician per 100,000 residents in 2000, but Staggers points to other studies that "provide a stark contrast":
- The Medical Board of California found that there were 159 physicians engaged in patient care per 100,000 Californians in 2000;
- A University of Pittsburgh study, which was based on the 2000 census, determined that California has 110 physicians per 100,000 residents, ranking the state 47th in the nation;
The Sierra Sacramento Valley Medical Society found that the number of active physicians in Sacramento and El Dorado counties declined by 12% between 1995 and 2000, while the counties' population increased 10% during that same time period.
- The California Medical Board, the Medicare Payment Advisory Commission and the Department of Consumer Affairs report that the physician-patient ratio "is declining" in California.
Staggers writes that the discrepancy between the UCSF study and the other studies is due in part to the UCSF study's definition of "active physicians," which included some physicians who worked "as few as 20 hours per week." According to the American Medical Association, California physicians work an average of 51 patient-care hours per week, Staggers notes. To "end the debate about physician supply" in California, the medical association is sponsoring a bill (AB 1586) that would "enable the Medical Board to compile information about physician specialties and hours of practice," Staggers writes. The medical association also is asking for an increase in Medi-Cal funding. Staggers concludes, "We can avoid a statewide crisis in patient care if we focus on the health care problem now. Dwindling patient access and physician supply deserve the attention of every Californian" (Staggers, Sacramento Bee, 4/27).
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