The ratio of health providers to patients in underserved areas is especially concerning, as limited access to care affects an individual’s health as well as the health of the community at large. One in five Americans lives in a Health Professional Shortage Area—geographic, demographic, or institutional areas where there are shortages of primary medical health care providers—and approximately 25 million individuals reside in dental health professional shortage areas.
Members of racial and ethnic minority groups represent a disproportionate number of these individuals. For example, 28 percent of Latinos and 22 percent of African Americans report having little or no choice in where to seek care, while only 15 percent of whites report this difficulty. The shortage of health professionals in rural areas contributes to the racial-ethnic and rural-urban health care disparity gaps.
Expanding the health care workforce and tackling the difficulties of recruiting and retaining medical professionals in underserved areas are critical components of health care reform. Both the bills currently under consideration address these issues.
The bills offer an array of incentives to encourage a range of needed health professionals to work in primary care settings, in public health services, and in areas of workforce shortage. The bills would reform graduate medical education to train more primary care providers by redistributing residency positions, promoting training in outpatient settings, and supporting the development of primary care training programs.
More efforts will arguably be needed to recruit and retain the health workforce in underserved areas. Issues such as workforce flexibility and role substitution will also need to be considered to ensure that people living in these areas have timely access to care. For instance, greater use of nurse practitioners, physician assistants, nurse-midwives, and dental technicians may be appropriate.
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