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How Can California Solve Family Physician Shortage?

With a shortage of primary care physicians, lack of resources to educate new ones and low Medi-Cal reimbursement rates discouraging physicians from treating low-income patients, California’s health care system is facing a scarcity of physicians on the eve of a major expansion.

Aging physicians are retiring and new ones are not being trained in sufficient numbers or quickly enough in many parts of the country, but the problem is particularly acute in the most populous state. Only one in four California counties has the recommended ratio of 60 to 80 primary care physicians for each 100,000 residents, according to the California Medical Association.

Things are about to get considerably worse. Roughly six million more Californians will be newly insured in 2014 because of the Affordable Care Act and about half of them will be eligible for Medi-Cal, California’s Medicaid program. The three million or so with private insurance will have a hard enough time finding a physician, but Medi-Cal recipients may have an even harder time. Only 57% of California’s physicians are willing to accept new Medi-Cal patients.

California has nine medical schools, with a 10th and 11th in the planning stages. A proposed medical school at UC-Riverside is caught in a predicament: The school did not receive preliminary accreditation partly because the national accreditation panel had concerns the school would not get state funding.

In planning stages for years, the school was scheduled to open next fall, carrying hopes of easing a severe physician shortage in the Inland Empire. Another medical school — still early in the planning stages — is proposed at UC-Merced. The fate of UC-Riverside’s medical school could have a bearing on what happens in Merced.

One new medical school — even two new schools — would help, but they alone won’t entirely solve the dearth of primary care doctors in California.

What will? We asked experts and stakeholders what California policymakers can do to encourage a healthy supply of family physicians.

We got responses from:

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