Primary care has been identified as an area particularly lacking in physicians. This is a worrying phenomenon because the number of primary care physicians has also been positively and consistently correlated with better health outcomes and lower utilization of health care resources. The supply of primary care physicians has been associated with an increase in life span, better outcomes including age-specific mortality rates; and decreased mortality from cancer, heart disease and stroke; low birth weight; life expectancy; and self-rated health1,2,3 Shi and Starfield (2000) also reported that individuals who live in US states which have a higher ratio of primary care physicians to the population are more likely to report good health.4 Similarly, in the UK it was reported that the ratio of general practitioners to the population was related with a decrease in mortality rates and acute hospital admissions. Furthermore, in-hospital death rates were significantly reduced by increased numbers of general practitioners in the community.5
Specialist shortages can cause patients to overburden general medicine, exacerbating the primary care physician deficit. Similar to primary care physician shortages, specialist shortages can overburden practices and departments, resulting in longer waiting times, and severely restrict access to specific care for patients living in areas where shortages are most acute.6
Conclusion
Without primary care, the health care system could become increasingly fragmented and inefficient, leading to poorer quality care. Consequently, it is likely that a shortage of primary care and specialist physicians will result in poorer health outcomes and more premature and preventable deaths.
Throughout the world it can be seen that physician shortages harm the quality of care provided to the general population, negatively affecting the accessibility, efficiency and safety of care. Conversely, sufficient numbers of physicians leads to better health outcomes and in turn a healthier population.
1 Farmer FL, Stokes S, Fiser RH, Papini DP. Poverty, primary care and age specific
mortality. J Rural Health. 1991;7:153-169.
[1]2[1] Shi L. Primary care, specialty care, and life chances. International Journal of Health Services.
1994; 24:431-58.
[1]3[1] J. Macinko; B. Starfield; L. Shi, “Quantifying the health benefits of primary care physician supply in the United States.”, International Journal of Health Services: planning, administration, evaluation;37(1):111-26, 2007
[1]4 L. Shi & B. Starfield, “Primary care, income inequality, and self-rated health in the United States: a mixed-level analysis” International Journal of health services: planning, administration, evaluation, ;30(3):541-55, 2000
5 B. Jarman; S. Gault; B. Alves; A. Hider; S. Dolan; A. Cook “Explaining differences in English hospital death rates using routinely collected data” British Medical Journal; 318:1515-20, 1999
[1]6 S. Harris, “Physician Shortage Spreads Across Specialty Lines” Association of American Medical Colleges, last accessed on April 6th 2011