How the Affordable Care Act will affect the physician shortage in primary care

Key Points

"It's almost a mortgage," she says. "That's pretty substantial as a primary care physician [PCP] not making the salary that a specialist is making."

Despite having chosen what many would regard as a more difficult career path-practicing primary care in an underserved area and likely receiving the paycheck that confirms it-Hamilton says she doesn't have any regrets.

The NHSC and Title VII of the Public Health Services Act are two of the most important federal programs designed to not only increase the number of PCPs across the nation but also boost primary care in underserved areas, says Christiane Mitchell, director of federal affairs for the American Association of Medical Colleges (AAMC).

Increasing access to primary care, and to physicians in general, are issues that are likely to take on increased importance in the coming decades. The AAMC predicts a nationwide shortage of 130,600 physicians by 2025, with primary care accounting for just more than half of the shortage.

The changing nature of the problem is observed in Merritt Hawkins' shifting customer mix, according to Bohannon. "We started recruiting for primary care in small towns, but we've seen our business evolve to the point where it is now more than half a mix of primary care and specialty care in metro communities," he says.

"No one has enough doctors," he adds. "It doesn't matter where you are."

Bohannon pointed to a 2011 survey from the Massachusetts Medical Society that the primary care shortage has arrived in more densely populated states. The survey found that access to PCPs is becoming more restricted as more than half of primary care practices-51 percent of internists, and 53 percent of family physicians-were not accepting new patients.