Tonight we're looking into what's causing the shortage of primary care physicians in the United States. What impact will health care reform have on this trend? We're also digging deeper on what really caused the attack of the killer whale on the trainer at Sea World this week. What do you think? Join the conversation on the live blog.
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Tonight, new details on the killer whale attack at Sea World. We’ll tell you what happened inside the tank as a massive whale named Tilikum held his victim in his jaws, underwater, for nearly 40 minutes. Did the 40-year-old trainer make a fatal mistake in the moments before the whale grabbed her?
Also tonight: broken government, family doctors and your health. We’ll be digging deeper on one piece of the heath care reform puzzle—a trend that could leave you in the lurch when you need to see a doctor.
Over the next decade, the American Academy of Family Physicians predicts a shortage of as many as 40,000 to 50,000 primary care doctors. Fewer medical school students are choosing to go into this line of medicine. We’ll look at the reasons why and what health care reform promises to do about it. 360 MD Sanjay Gupta heads up our coverage.
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Three men walk their dogs in Central Park February 26, 2010 after a snow storm dropped 9.4 inches (23.8 cm) in New York. More snow is expected in the next two days.
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Kaiser Family Foundation
State Health Facts
In the debate surrounding overhauling the nation's health care system, one factor keeps coming up: the shortage of primary care physicians. Tonight, we're digging deeper on this phenomenon and taking a look at what health care reform will mean for the number of doctors in America. Are medical students steering clear of primary care? Why? Take a look at this map from the Kaiser Family Foundation. It shows the "shortage areas" by region. You can search by state to drill down on the most recent numbers.
There are 6,033 Primary Care Health Professional Shortage Areas (HPSAs) with 64 million people living in them. It would take 16,336 practitioners to meet their needs for primary care providers (a population to practitioner ratio of 2,000:1).
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Boyce Watkins, PhD
One of the obstacles being faced by President Obama as he works to overhaul the health care system is the shortage of doctors across America. Our country is woefully unprepared for the number of primary care physicians that we will need as the American population ages. The problem is that fewer doctors are interested in doing primary care, since the medicare payments to primary care physicians are lower than those made to specialists. As a result, there's been a 51.8% decline in the number of medical school students going into primary care since 1997.
The American Academy of Family Physicians predicts that by 2020, we will be short 40,000 family physicians relative to what our nation will need by that time. The American Medical Association is one of the primary culprits in the doctor shortage. A 1994 article, as well as many conferences during the 80s and 90s, predicted a 165,000 surplus in the number of doctors by the year 2000. As a result, medical schools agreed to voluntarily restrict the supply of medical students entering their programs. The only problem was that the predicted surplus never occurred. Instead, we got a shortage.
Dr. Elaina George, a prominent physician out of Atlanta, says that the doctor shortage is going to have lasting consequences on the American public.
"In the short term, there will likely be a decrease in access since we will be unable to accommodate the increase in patients," says Dr. George, one of the few black doctors willing to discuss health care reform in public. "In the long term a patient will have to wait even longer to see a specialist."
Kaiser State Health Facts
Data are for December 2008. U.S. total includes territories and persons from the Pacific Islands.
Nonfederal physicians represent 98% of total physicians. They are not employed by the federal government and include allopathic physicians (MDs) and osteopathic physicians (DOs). Data include retired and inactive doctors (approximately 12% of all nonfederal physicians.
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Special to CNN
I've spent more than 25 years making wildlife films, many of them about powerful and dangerous predators such as killer whales. It is easy to see that in their own environments, little prevents such creatures from yielding to their natural impulses, as they should.
Wednesday's tragic accident at SeaWorld Orlando shows that we need to reconsider keeping wild animals in captivity for our entertainment and take a hard look at our own understanding of the natural world.
The stakes have been raised for those who argue that the pros of performing animals in captivity (protection and conservation of wild animals, public education) outweigh the cons (forcing animals into confinement, risking critical or fatal human injuries).
Trainers at SeaWorld are taught to reinforce the whales' good behavior with rewards and to not react at all to bad behavior.
Killer whales can weigh up to 22,000 pounds, and may be as long as 32 feet, according to the National Oceanic and Atmospheric Administration. They often travel in groups of up to 50, being highly social.
Confining such an enormous animal in an aquarium tank leads the animal to display neurotic behavior, experts say.
"They get very stressed out," marine biologist Nancy Black of Monterey Bay Whale Watch said on CNN's "Larry King Live."
SeaWorld whale trainer Dawn Brancheau, 40, died Wednesday from "multiple traumatic injuries and drowning" after a whale called Tilikum grabbed her ponytail and pulled her underwater at Shamu Stadium, the Orange County Sheriff's office said Thursday.
An orca can travel easily 100 nautical miles every day, and to put them in a pool where they swim around in circles continually, and kept away from their families, "takes a toll on their brains," said Jim Borrowman, who has worked with whales for 30 years and runs Stubbs Island Whale Watching on Vancouver Island, British Columbia.