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Obamacare: Will it worsen Missouri's doctor shortage?

Obamacare: Missouri already has a shortage of primary care doctors. When Obamacare (the Affordable Care Act) goes into effect on Jan.1, some say the ratio of patients to doctors will get even worse.

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Senate clerks arrange 95 proposed amendments to the health insurance exchange bill at the statehouse in St. Paul, Minn., earlier this year. Minnesota will set up its own health insurance exchange to comply with Obamacare, but the federal government will do it on behalf of 34 other states.

Glen Stubbe/The Star Tribune/AP/File

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Missouri is facing a shortage of the primary care doctors. The strain could grow as more Missourians soon gain health insurance under the federal health care law.

"A lot of folks say that politics is the biggest threat to Obamacare or the Affordable Care Act. I think the second biggest threat is the lack of primary care providers to serve the folks who are going to gain access to coverage," said Joe Pierle, CEO of the Missouri Primary Care Association that represents community health centers. "We can give everybody health insurance, but if they can't get in to a doctor, especially in rural Missouri, then we're really not making much progress."

Nationwide, the shortage of family doctors stems from a populace that is getting older and a desire by doctors to seek out specialties with better pay and hours. A shortfall of primary care doctors can mean more difficulty scheduling appointments and longer waits while reduced preventive care can push patients' health problems into chronic conditions. Clinics more frequently are using search firms to find practitioners.

Missouri had a little less than 74 active patient care primary care doctors per 100,000 residents in 2010 according to figures from the Association of American Medical Colleges. That ranked 35th and put it behind the national per capita average of more than 79 active primary care doctors. Among its neighbors, Missouri had fewer doctors per 100,000 residents than Illinois, Iowa, Kansas, Nebraska and Tennessee.

Access to a primary care doctor seems a particular issue in Missouri's rural areas. The medical school at the University of Missouri-Columbia has a pipeline program aimed at increasing supply and retention of rural doctors that includes but is not limited to family medicine.

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