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Updated 06/28/2012 07:48 PM

Supreme Court ruling means medical schools need to train more doctors

With the individual mandate upheld, more than 60 million Americans will enter the heath care system over the next several years. Health care professionals are celebrating the Supreme Court Decision. But as our Katie Gibas reports, there's still a lot of work to be done to ensure the law's success.

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SYRACUSE, N.Y. -- If you've tried to go to the doctor's office lately, you may have had to wait a while to get the appointment and then wait some more to actually see the doctor. And with the Supreme Court upholding the Affordable Care Act, it's about to get worse as millions of uninsured people enter the system.

"The original provisions to train more doctors and more primary care doctors were stripped from the bill early on. We've got to come back and deal with that as a country. And to be controversial, this state and this country do not have a strategic plan for health labor forces," said Dr. David Smith, the Upstate Medical University President.

That means the task is falling back on the medical universities and hospitals to provide incentives for students to go into primary care.

"You always hate to think everything comes back to dollars, but some of it comes down to what is the reimbursement for a primary care doctor versus the reimbursement level is for a specialist. There's a marked discrepancy and with medical students come out with $200,000 plus in loans, it's hard to pursue a career where your income opportunities are somewhat limited," said Dr. David Page, the Onondaga County Medical Society President.

Upstate Medical University will have to grow their class by 30 percent just to meet the needs in Central New York, something Smith says should have been done five years ago, but has been limited by state funding cuts.

"The amount of reduction in state support in the area of academic medical centers over the last three years has been dramatic. We're down to less than eight percent of our budget being state even though we're a SUNY. That disinvestment has got to change if we're going to begin address the rural, urban, inner city and the diversity that's out there," said Smith.

And that's why medical schools are having to be creative to attract people to primary care, such as considering moving from four years undergrad and four years medical school to three and three for those focusing on primary care.

"You're losing some of your electives that we have within the curriculum, not the core. So I want to make sure that's clear. For your debt, for your payment for your loans, you're now instead of paying for eight years of debt and service, which may push you nationally, to well over $200,000 in debt, it would reduce that dramatically," said Smith.

Medical schools and hospitals are also working to recruit and train more physician's assistants and nurse practitioners to help build a better primary care team. But in the short-term, there's no question the shortage will get worse before it gets better.