WASHINGTON, Ind. – It didn’t take long for Dr. Rex Stroud to feel like he had more patients than time to see them.
Two years ago, after working in emergency medicine, Stroud opened a primary care practice in this small southwestern Indiana town of 10,500 people. He was soon hit with a wave of people calling for appointments.
Many were older with chronic health problems that required more of his time. Stroud brought in two part-time nurse practitioners and a physician’s assistant to help manage the caseload.
Still, he routinely runs behind schedule.
“I make my office manager anxious,” Stroud said during a hurried conversation in his modest office near the local hospital. “Spending longer time with patients isn’t good from a business standpoint, but from a patient relationship standpoint it is a good thing. I can’t do it any other way.”
He’s not the only busy doctor. Some of his colleagues in neighboring towns are turning away new patients or making appointments several months out. Daviess County is among Indiana’s least-served by primary care providers.
The strain is likely to get worse as Indiana increases access to health insurance through the Affordable Care Act.
After initially resisting the federal government’s call to expand the traditional Medicaid program, Gov. Mike Pence has proposed using the state’s Healthy Indiana Plan to expand coverage by early next year. If approved, it would add more than 400,000 low-income Hoosiers to the rolls of the newly insured. Many, having put off seeing a doctor they couldn’t afford, are expected come in with chronic – and time consuming – health problems.
“We’re quickly going to be saturated with more patients than we can handle,” said Stroud.
Demand will grow
Dr. Richard Feldman, Indiana’s former health commissioner, has warned about the national shortage of primary care physicians. The dwindling supply of doctors who provide preventative care is what he calls a “looming crisis that’s been smoldering for years.”