When you get sick and exhaust all your home remedies and family's advice, chances are you go see a doctor. A good old-fashioned doctor, who whips off his stethoscope to listen to your heart and lungs, who asks you to say "ahhhhh" while looking at the back of your throat, and who shines a tiny flashlight beam into your pupils.

This good old-fashioned doctor, also known as a primary care physician, is the front-line person for most patients. The problem is, this type of doctor is in short supply in California. Also in short supply are all the people who work with primary care physicians, such as pharmacists, laboratory workers, radiologic technicians and technologists, advanced practice nurses, and physician assistants, according to a newly released UC report entitled "Impact of National Health Care Reform on California's Health Workforce."

"The central point of this report is that health care reform will increase demand for health professionals, especially primary care providers," said the report's co-author Janet Coffman, who is an adjunct professor with the Phillip R. Lee Institute for Health Policy Studies at UCSF. "Therefore, we need to increase the overall supply of health care workers in California."

Coffman co-authored the report along with Gil Ojeda, director of California Program on Access to Care (CPAC). CPAC, which funded the report, is a program of UC Berkeley's School of Public Health. "Today, 22 percent of Californians are uninsured," said Ojeda. "Come 2014, most of these Californians will be able to purchase affordable insurance under the new health care reform law. People who have health insurance are more likely to use it. But where are all the health care workers for this new influx of patients?"

The UC report points to specific programs and grant monies available to train more health care workers.
"For example," said Coffman, "there is a program called the National Health Service Corps, which provides scholarships and loan repayment to people who want to become primary care, mental health or dental professionals and are willing to spend at least two years practicing in federally designated Health Professions Shortage Areas. These kinds of programs could attract more people to our health care work force."

Coffman noted that in September 2010, the Obama Administration awarded $29 million in grants to California's health professions schools and state government agencies to try to boost the numbers of primary care providers, public health professionals and direct care workers.

The UC report also looks at ways to use the current work force more efficiently, particularly in rural and inner city areas that already suffer from primary care shortages. "We could use new federal funding to increase Medi-Cal payments to primary care doctors. Increasing payment rates would encourage more California doctors to participate in the state's Medi-Cal program serving the very poor," said Coffman.

On Sept. 30, 2010, Gov. Schwarzenegger signed legislation making California the first state to establish a health insurance exchange under the new reform law. As many as 2.4 million Californians will be eligible to purchase subsidized coverage through the exchange, and as many as 2.1 million will be eligible to purchase unsubsidized coverage.

That's a lot of people.

"Our state leaders need to move quickly to fill the impending primary care void in our state," said report co-author Ojeda. "This UC report can help leaders identify funding and programs to train more health care workers."

The California Program on Access to Care, which funded the report, is an applied policy research program administered by UC Berkeley School of Public Health with the support of the University of California Office of the President. CPAC's activities provide independent research and analysis to state decision makers, including legislators and government agency leaders. CPAC works to expand health care access for the state's most vulnerable populations, including immigrants, agriculture workers, the working poor and other low-income groups.

The Philip R. Lee Institute for Health Policy Studies is one of the nation's premier centers for health policy and health services research, bringing together a multidisciplinary faculty versed in medicine, law, ethics and pharmacology. The institute focuses on providing information about policy decisions that will affect people's health and lives.