In the present day, the increasing shortage of primary care providers across the United States may be regarded as one of the most disturbing and time-critical issues of public policy. According to the data from the latest reports, the shortage of primary care physicians in the country is currently more than eight thousand specialists, and this number is dramatically growing (“Nurse practitioners and the primary care shortage,” n.d.). Only 58% of the United States have appropriate levels of primary care providers to serve the population to the full extent, however, by 2025, 37 states are projected to experience difficulties related to the lack of health care providers (“Nurse practitioners and the primary care shortage,” n.d.). The main reasons for this tendency generally include an aging population, the shortage of medical school graduates, and the general development of the health care system with a related growth of insured citizens.
The increasing shortage of primary care is a challenging public policy issue for the State of Illinois, as well. Its significance is determined by the subsequent deterioration of the quality of life for a substantial number of Illinoisans, predominantly in the rural parts of the state. Populated by talented, innovative, and caring citizens, Illinois covers 57,914 square miles and has 102 counties (Illinois Rural Health Summit Planning Committee, 2018). However, despite its general development, disparities connected with limited access to health care services exist “in the livelihood and opportunities available for people living in the state’s 62 non-metropolitan counties” (Illinois Rural Health Summit Planning Committee, 2018, p. 1). According to the report presented by the Illinois Rural Health Summit Planning Committee (2018), approximately 1.5 million Illinoisans struggle to maintain active, productive, and healthy lives due to the shortage of primary care physicians. In comparison with the urban part, rural and underserved counties have significantly higher rates of obesity, smoking, teen pregnancies, and mortality from the leading causes of death. In addition, mental services are poorly provided in non-metropolitan counties most notably.
As a matter of fact, rural territories of the state have a considerable shortage of primary care providers due to the absence or closing of hospitals as more uninsured adults who cannot afford health care live in rural counties. More than 30% of small and rural hospitals “are in designated primary care physician shortage areas,” while almost 94% of rural hospitals have a lack of mental health services (Illinois Rural Health Summit Planning Committee, 2018, p. 2). That is why the rural areas of Illinois have the highest rates of opioid prescriptions and related overdose deaths in comparison with the state’s urban counties. Moreover, from 2011 to 2015, the rate of the neonatal abstinence syndrome in rural counties increased more than 200 % (Illinois Rural Health Summit Planning Committee, 2018).
In addition, as previously mentioned, an aging population is among the main reasons for the shortage of healthcare providers across the country, and this issue has become crucial for Illinois as well. According to the Illinois Department of Commerce and Economic Opportunity (DCEO), age 85 and older may be regarded as the fastest-growing population group that will increase by 109% after 10 years (Illinois Rural Health Summit Planning Committee, 2018). Limited health care services due to a lack of primary care providers and readmission rates in rural areas have a highly negative impact on the aging population of Illinois.
It goes without saying that the shortage of primary care providers in Illinois, especially in non-metropolitan counties, should be alleviated in the near future as it strongly affects citizens’ well-being. According to the Robert Graham Center (n.d.), by 2030, Illinois will need an additional 1,063 primary care physicians, a 12% increase in comparison with the state’s current workforce. In order to meet the population’s health care needs, policymakers in Illinois should consider various strategies “to bolster the primary care pipeline including reimbursement reform, dedicated funding for primary care Graduate Medical Education (GME), increased funding for primary care training and medical school debt relief” (Robert Graham Center, n.d., p. 2). Other potential solutions that may reduce the shortage of primary care providers, especially in the rural areas of the state, include:
- Provision of income tax credits to social funds that are permanently endowed to support unmet rural economic and health needs;
- The development of Medication-Assisted Treatment (MAT) programs and telepsychiatry, in general, to provide behavioral counseling and reduce opioid use (Illinois Rural Health Summit Planning Committee, 2018);
- The development of specific social programs for primary care physicians in order to attract them in non-metropolitan states (good salaries, reduced taxes, free accommodation);
- The provision of autonomy for nurse practitioners. Illinois is the state where the performance of nurses is reduced (“Where can nurse practitioners work without physician supervision?” n.d.). In other words, they have an opportunity to diagnose and treat patient, however, physician oversight is required to prescribe medications. The autonomy of nurses, especially in rural hospitals, will have a positive impact on health care delivery and patient outcomes.
Illinois Rural Health Summit Planning Committee. (2018). The state of rural health in Illinois: Great challenges and a path forward. Web.
Nurse practitioners and the primary care shortage. (n.d.). REGIS. Web.
Robert Graham Center. (n.d.). Illinois: Projecting primary care physician workforce. Web.
Where can nurse practitioners work without physician supervision? (n.d.). Simmons University. Web.