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h e alTh c ar e r efo r m by Th e n u m b ers wHile a SHoRtage of physicians and dealing with insurance companies have been trending topics for years in the medical world, the Affordable Care Act could amplify these trends further. Here���s a look at how physicians and patients will be affected as this new law progresses. + New doctors and nurses needed! The Association of American Medical Colleges has called for a 30% increase in U.S. medical school enrollment by 2015. Nurses have also been short staffed since the early 2000s. In the meantime, the Affordable Care Act plans to manage the shortage by incentivizing resident physicians to serve patients in specially designated health professional shortage areas. + more patients, more problems? Approximately 32 million Americans will enter into the health care system, with 15 million new Medicare patients trickling in over the coming years. However, increases in national health care costs have dropped from 7% a year to 4% a year and have held steady since President Barack Obama signed the Affordable Care Act into law. physicians by 2015, when most of the changes mandated by the Affordable Care Act will be in full effect. These shortages will continue to increase, with the nation lacking an estimated 91,500 physicians in 2020 and 130,600 in 2025. To help meet increased demand, the Obama Administration has made $168 million available for training nearly 500 new primary care physicians by 2015. However, as Ardis Hoven, M.D., President-Elect of the American Medical Association, pointed out in a July 2012 interview with The Washington Post, the predicted physician shortage has long been an issue and will not be an overnight fix. weighing the bene���ts The increase in patients and decrease in medical professionals presents a puzzle for physicians: How will they continue to provide patient-centered care with millions of more patients entering the system? ���I am a physician who abides by the original Oath of Hippocrates,��� says Alieta Eck, M.D., a board-certified internal medicine physician and immediate past president of the Association of Physicians and Surgeons. ���My loyalty is to my patient and my patient alone.��� Having maintained a private practice since 1988, Dr. Eck is also co-founder of the Zarephath Health Center in Somerset, NJ, which administers care to the poor and uninsured. Rather than adopt changes initiated by the Affordable Care Act, Dr. Eck is maintaining her own model of patient care so she can ���continue to see the patients who need me.��� Like Dr. Eck, some physicians wrestle with reconciling health care reform measures and their desire to practice quality medicine in a way that best benefits patients. In May 2012, the Doctor Patient Medical Association Foundation surveyed 699 physicians about their attitudes toward medicine today. When asked if it was becoming ���easier or more difficult [to] adhere to a Hippocratic ethic of medicine,��� 61% of respondents answered ���more difficult.��� In the same survey, 90% of physicians indicated the overall path of the U.S. health care system was on the ���wrong track.��� According to Thomas H. Lee, M.D., network President of Partners Healthcare System and professor of medicine at Harvard Medical School, changes ushered in by new care models may create difficulties in the short term, however, these challenges are a ���logical consequence from the imperative to take care of everyone with limited resources.��� ���The Affordable Care Act will add complexity to some aspects of health care as organizations re-tool, and it may increase some costs in the short term,��� Dr. Lee wrote in a Harvard Business according to an april 2012 survey conducted by mdlinx, many physicians are concerned about going out of business, with 17% reporting they foresee closing their private practices within a year if their ���nancial numbers don���t rise. the survey polled 673 physicians in both private practices and hospitals across the country. Review column the day after the U.S. Supreme Court decision. ���But ultimately it will improve the quality of patient care and reduce costs as providers and their organizations focus as much on keeping people healthy as they do on healing them when they���re sick. That���s something patients, providers and employers who subsidize care ��� and want healthy employees ��� should be happy about.��� How will the Affordable Care Act affect your practice? Sound off at www.MDNews.com. ��� mdNewS.com ��� MD News Central New York | 15