Rollout of the controversial Affordable Care Act will be largely complete as of January 2014, giving 30 million more Americans access to insurance, and now there's growing concern there may not be enough primary care physicians to meet the need. NY1's Erin Billups filed the following report.
Marleny Encarnacion of Brooklyn is one of hundreds of thousands of New Yorkers that live in medically underserved communities. The federal government says a minimum of 50 primary care physicians are needed per 100,000 residents.
"Before it was really hard to get a pediatric doctor for my son and I was struggling with that," says Encarnacion.
Citywide, 2009 numbers show the ratio is 99 doctors per 100,000. In certain areas like in the North Bronx it goes as low as 34 doctors per 100,000.
Meanwhile, the Upper East side has a doctor-patient ratio of 261 to 100,000.
Marleny eventually found a medical-home at Brooklyn Hospital's La Providencia Family Medicine Center in Bushwick, where Dr. Natalie Langston-Davis serves as the director.
"As much as we can have the services available for the patient in the home where they live, it makes it less enticing to use the emergency room for that type of care," says Langston-Davis.
The focus on preventative care is a major component of the Affordable Care Act. But whether there are enough doctors to serve the estimated 600,000 additional city residents who will be gaining access to primary care through insurance is still to be seen.
"We already have a crowded waiting area. I see that increasing tremendously. So how that's going to impact on patient satisfaction is a major concern of mine," says Langston-Davis.
Dr. Davis grew up not too far from La Providencia and says it can be a struggle finding doctors who want to work in communities where there are physician shortages.
Shortage issues are also due to the small number of physicians who accept Medicaid.
It's a problem lawmakers in the nation's capital are scrambling to address, partly through greater incentives to entice more medical students to go into primary care.
Still, Greater New York Hospital Association President Kenneth Raske insists New York hospitals and teaching centers are setting up the infrastructure and are well prepared to deal with the influx.
"We are generating physician supply that far exceeds anything that you can see nationally," says Raske.