[INSPRATIONAL MUSIC STING] - Hi, everyone.

Steve Adubato.

Welcome to a very compelling program that we kick off with our longtime friend and colleague, Linda Schwimmer, President and CEO of the New Jersey Healthcare Quality Institute.

Good to see you, Linda.

- Good to see you.

Thank you.

- Linda, describe the primary care physician shortage in the state.

A, how bad is it?

B, what do we need to do to address it?

- Well, Steve, thank you for having me on and talking about this important issue.

We have to start working on this issue now.

The shortage in primary care physicians is a lot worse than we thought here in New Jersey.

The Quality Institute undertook a study recently, it was just released in January and when we looked at the data that we got from the board of medical examiners, it showed that the data that had been previously reported on the number of primary care providers or physicians was really overstated.

And it is worse than we thought.

There's about 5,300 primary care physicians in the state.

Other reports had put it at over 8,000 and over 6,000.

But of those 5,300, a lot of those are working less than 32 hours a week even and it's an aging group of docs.

So we need to start focusing on this as soon as possible.

- Linda, let's do this.

Beyond all the statistics, which sometimes can be confusing to people, put it in context as to what it really means for people who need care from a primary care physician.

- Sure.

Today, and you may have experienced this, I know I have, many people struggle to find a primary care doctor, particularly if you're looking for, you know, if you're a new patient and you're calling around, and then if you are insured through Medicaid, which pays about half of what Medicare pays, it's even harder to find a primary care physician to see you.

- Why?

- There's not enough of them, like I just mentioned.

Second of all, in Medicaid in particular, they're paid about 50 cents on the dollar compared to, in Medicaid, they're paid about 50 cents on the dollar compared to Medicare and overall nationally, New Jersey is at the bottom quartile when it comes to reimbursement for primary care docs.

So what happens- - Why?

- Why?

You know, I don't know why.

We do not value primary care physicians the way we need to value them.

On your show, I hear about fantastic innovations that are happening, new cancer centers, amazing technology things, but when you really think about it, everybody needs to see a primary care doctor.

Everybody needs to have that home base for preventive care, for testing, for screening, somebody they trust and they can go to.

Not everybody's going to need the fancy new technology that's just been developed and is cutting edge.

- But, Linda, go back to the question I asked.

Now when I ask why is that?

And if you don't know why, the question is, is it a state public policy question that needs to be addressed by the governor and the state legislature?

Who is supposed to address this?

- The answer is that our state public policy, our leaders, the governor, the legislature, and also our medical schools, we all need to be looking at this data and be asking ourselves: Where is the need?

What are we seeing?

Why aren't we training more primary care docs?

And why are the ones that we are training leaving the state?

We have a huge percentage of the primary care docs we do train leaving the state.

So what can we do to train more, to incentivize them to go into primary care and to stay here in New Jersey and make New Jersey their home to be taking care of us?

- Well, Linda, haven't you just described why they leave?

If reimbursement rates for Medicaid are too low, the lowest in the nation, and some of the reasons for people, anyone, even including physicians, beyond their commitment to caring for patients is an economic issue, if they can't pay their bills and their staff and themselves...

So we know in part why they're leaving, but what I'm asking is if it's a question of raising Medicaid rates, who is supposed to do that?

- So there's a bill pending right now that would mandate that, it's sponsored by Senators Ruiz and Vitale, and then in the assembly it's Speight and Conaway that would do it, that would mandate it because the state voluntarily has not done that to date.

It could do it, but it hasn't done it.

So that's one step, and that's an important huge step.

And that bill has been pending.

- Where are the bills?

Are they moving through the legislature?

Are they moving through the respective health committees in the lower house and the upper house and the Senate?

- Yes.

So it got out of the senate last year, but did not move in the assembly.

It just moved again in the senate.

Just got out of the Senate Health Committee.

- Who's against it?

- You know, it's a matter of dollars and cents.

It's a matter of what we're prioritizing.

I don't think anybody is truly against it.

It's just looking for, you know, how to pay for it.

But to those people, I would say we're already paying for it because when we don't have good primary care, what happens is we see more emergency surgeries, we see people going to the emergency room, - More expensive.

- We see spending in ways that are not as effective and end up, actually we see more harm to patients.

- Last question is where's the governor on this?

- I do not know.

I think that the administration- - If you don't know, nobody knows.

(both laughing) - I would say this, I think it comes down to the budget and dollars and cents.

I think that everybody in this administration that I've spoken to realizes the value of primary care, but it's putting your money where your mouth is and making sure that the investment in primary care takes priority over other things.

And when I say primary care, I mean family medicine, OB, midwifery and mental health as well.

That's what this bill would do.

It would raise the 50 cents on the dollar to a full dollar towards primary care.

And those are all things that people struggle with.

They struggle finding that type of care.

I see people waiting 45 days or more, you know, just to get in for a visit.

- Linda Schwimmer is President and CEO of the New Jersey Healthcare Quality Institute.

We've had their website up, check them out.

They do important research and help us understand from an educational point of view why these medical and healthcare issues are so important.

And they have no horse in the race, if you will.

They are doing independent research and important work.

Thank you, Linda.

We appreciate it.

- Thank you so much.

Thanks for highlighting this important issue.

- And we'll continue to do that.

Stay with us, we'll be right back.

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