What Happened to 2013 Healthcare Predictions?

Carol Peckham; Sarah E. Grisham, JD

Disclosures

December 19, 2013

In This Article

Editor's Note:
In January 2013 and after discussions with our editors and advisors, Medscape offered some predictions about what the upcoming year would hold for healthcare, in a slideshow titled Predicting Healthcare for 2013. We speculated about the early effects of the Affordable Care Act (ACA), the increasing acceptance of medical marijuana, screening issues, and the obesity epidemic. Would 2013 be the year of the genome? And, the now-annual question: Will the doc fix happen in 2013? In December, we reexamined that list of predictions and asked: How did we do?

The Affordable Care Act Makes Its Presence Known

The Prediction

The big question in 2013 will be what impact the ACA will have on medical practice. US physicians may face up to 40 million new patients once the individual mandate to obtain insurance coverage takes effect in early 2014. Physicians will appreciate having more insured patients, but can they handle the extra volume?

The Reality

As everyone in the country knows, the ACA launch was blunted by major problems with the government Website, so the expected volume of patients may be lower in 2014 than first estimated. Even if Congressional Budget Office (CBO) projections of 11 million newly insured Americans in 2014 and 24 million by 2016 hold, an analysis by RAND Corporation suggests that the increase in demand won't be as dramatic as feared.[1]

Nevertheless, in a Medscape interview this year, Perry A. Pugno, MD, MPH, Vice President of Education for the American Academy of Family Physicians (AAFP), stated that the United States will need 40,000 additional family physicians by 2025, and that the pay structure for primary care may still be a big part of the shortage.[2] In another interview, Reid Blackwelder, MD, the AAFP President, said that the aging population is another major factor in increased demand for primary care physicians.[3] This is supported by information from a national healthcare recruitment firm, which reported that in 2013, employers requested significantly more geriatricians than in past years.[4]

The American College of Physicians issued a policy paper in September[5] addressing one of the key issues surrounding the shortage of primary care professionals: the role of nurse practitioners and physician assistants. Although the paper stopped far short of saying that these clinicians should direct care independently, its tone was somewhat collaborative and team-focused. However, the final point was a request for existing state laws to be reviewed: "State legislatures should conduct an evidence-based review of licensing laws to ensure they recognize that the skills, training, clinical experience, and competencies of physicians, nurses, physician assistants, and other health professionals are not equal and not interchangeable."

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