After a painful, summer-long labor, Senate Finance eventually had to be induced before it gave birth to a health reform bill of its own. But give birth it finally did, and the products of its conception now stand alongside the offspring of 4 other proud Congressional committees.

But please! Save the silver spoons and bunting! None of the quintuplets does enough to assure there will be enough PCPs out there to meet the surge in demand for their services which will inevitably occur if health reform legislation actually passes.

Among the herd of elephants in the health reform room, the impending PCP manpower crisis has got to be one of the biggest.

The American Academy of Family Physicians estimates that even without health reform the US will be short 40,000 family physicians within 10 years. When all PCPs are considered, the Association of American Medical Colleges predicts a deficit of 160,000 by 2025.

“I don’t see anything in the legislation that will greatly increase the primary care pipeline,” Russell Robertson, chairman of the Council on Graduate Medical Education told Kaiser Health News.

Everyone knows that a solution to the problem requires that training programs create more positions for PCPs at teaching hospitals, and that those choosing to pursue the noble profession receive a bump in reimbursement from Medicare and the privates.

Problem is, both steps cost a fortune which nobody has right now. For example Senate Majority Leader Harry Reid’s proposal to implement a PCP-friendly increase in Medicare-funded residency positions was booed off the stage after he announced it would cost $10 billion over 10 years.

It didn’t matter that the total price tag on health reform could run a hundred times that.

To be sure, the quintuplets do include clauses that reallocate about 1,000 unfilled residency openings to PCP-friendly residency programs, but this amounts to about 7% of what Reid had proposed, and calling that a drop in the bucket would be giving it more homage than it deserves.

And proposals to bump Medicare payments to PCPs were dead on arrival thanks to protracted efforts from—here’s a shocker—specialists, from whose hide the benefits would have been extracted.

Right now, family doctors make less than half of what specialists rake in. That sounds fair, huh?

Glenn Laffel is Sr. VP, Clinical Affairs at Practice Fusion.

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