Back to Front PageVOLUME 6, NUMBER 4
 

Sam S. Shekar, M.D., M.P.H. Director, Bureau of Health Professions Health Resources and Services Administration

The problem with health care in America is simple: Too many people-more than 44 million-lack access to adequate health care services, oftentimes because health care professionals aren't available to meet their needs.

Health care providers are few and far between in many of our nation's inner-city and rural areas, a fact that is frequently overlooked in evaluations of the state of health care in America. While the ranks of health care professionals overall may seem high, their distribution is concentrated in suburban and wealthier areas. As a result, tens of millions of Americans live in neighborhoods where primary health care services are scarce.

And the number of providers available to care for Americans could decrease even further. Concerns have been voiced about impending or actual shortages in the nation's four largest health professions-nurses, physicians, dentists, and pharmacists-especially when it comes to underserved areas and populations.

The Bureau of Health Professions' (BHPr) mission is to strengthen the nation's capability to provide services to Americans who lack sufficient access to health care by improving the distribution and quality of health care providers. BHPr spends $342 million annually on 40 training and educational programs to meet emerging health care needs of the nation's increasingly diverse population.

In addition, BHPr spends some $160 million on other health care programs, such as the new Children's Hospitals Graduate Medical Education Program, National Practitioner Data Bank, Health Care Integrity and Protection Data Bank, Vaccine Injury Compensation Program, and Ricky Ray Hemophilia Relief Fund Program.

To ensure that providers are ready and able to meet the challenges of health care in the 21st century, BHPr has identified three priorities: geriatrics, genetics, and diversity.

First, we are working to prepare health care professionals for a dramatic increase in the elderly population. Over the next 30 years, the number of Americans age 65 and older is expected to double to 70 million, while the 85-and-older population is expected to rise to 19 million by 2050. The aging of America has serious implications for our health care system and the quality of care for older people. Increased longevity brings the need for more trained health care professionals who know about the aging process, the presentation of diseases and disabilities in old age, and age-appropriate treatments and supportive services, including rehabilitation, acute care, and long-term care.

BHPr is spending approximately $10 million annually on training in geriatrics care through three principal programs: Geriatric Education Centers, which form a national network that educates health care professionals; postdoctoral institutional geriatric training programs for physicians, dentists, and behavioral and mental health professionals; and Geriatric Academic Career Awards, designed to increase the number of geriatrics faculty at U.S. medical schools.

While our first priority focuses on a rapidly growing patient population, our second zeroes in on a field of medicine and science that has the potential to revolutionize health care. BHPr has launched a number of initiatives to assess and expand the level of genetics education, including a "Genetics in Primary Care" faculty development initiative and an expert panel on genetics and nursing. We are also funding research projects on the genetics work force that will assess the practices and professional activities of genetics specialists and establish a system to monitor demands for genetics services.

Fostering diversity in the health care professions is our third priority. We perceive a great need for encouraging promising students from all racial and ethnic backgrounds to pursue a health professions career, particularly given the fact that underrepresented minorities make up 25 percent of the American population but less than 10 percent of health care providers.

Why are we concerned about underrepresented minorities? Because we know that minority communities are more likely to experience shortages of physicians and other health care providers. And we know that BHPr-supported educational programs graduate three to five times more minorities who are increasingly likely to return to those communities and provide much needed care to some of the millions of underserved Americans.

Programs such as our new "Kids Into Health Careers" campaign are designed to expand the educational pipeline to young people from minority and disadvantaged backgrounds. BHPr's efforts to attract the best and brightest racial- and ethnic-minority students into health education programs will ensure that more bilingual, culturally sensitive medical professionals are available to meet the health needs of their patients.

Partnership is the key to reaching these goals as well as our ultimate aims of ensuring 100 percent access to health care and eliminating all health disparities. We know we can't do it alone; we're counting on groups like the AAMC to provide advice and guidance on emerging work-force issues and how best to design, implement, and collaborate on programs and projects that target our priority areas. We hope to hear from you in the weeks and months ahead as we plan our agenda for 2001. With you and our other partners, we will succeed.

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