Physician Need Still Outstrips Rising Supply In California
Cheryl Clark, for HealthLeaders Media
, July 26, 2010
California doctors are less likely to see Medicaid patients or uninsured patients. While 90% have patients with private insurance, 69% accept patients covered by Medicaid and 65% accept uninsured patients.
Pay for performance is a declining trend in the state. In 2005, P4P peaked, with 45,000 physicians participating, but in 2008, that number had declined to 35,000.
With respect to physician earnings, family and general practitioners in California earned 88% of what their counterparts across the country earned, and obstetrician/gynecologists earned 94%. On the higher end, anesthesiologists earned 106%, followed by pediatricians, 102% and psychiatrists, 101%.
One issue that is increasingly important is linguistic competence among the nation’s physicians. “Not having access to a provider who speaks their language can have a negative impact on quality of care,” the foundation report says. Perhaps somewhat surprising, San Diego County, a major county closest to the border, has the lowest percentage of physicians who speak Spanish in the state, only 11% compared to the statewide average of 18%, and lower than other regions.
Another concern about physician supply is the numbers who now refuse new patients, especially if they lack health coverage. While 84% of the state’s primary care providers and 94% of other physicians will accept new patients, only 64% of primary care providers accept new patients covered by Medicare, 54% will take new patients if they have Medicaid and 42% if they lack any coverage. For non primary care providers, the numbers are slightly higher. About 94% will accept new patients, but 79% will take new Medicare enrollees and 59% if covered by Medicaid and 47% if they are uninsured.
In 2008, California was best in the nation for retaining medical school students and was second in the nation for retaining residents.