In January of this year, the American Hospital Association released a report entitled “Workforce Roles in a Redesigned Primary Care Model.” This document was largely created from a roundtable discussion by nine physician and nurse leaders who were asked to develop some recommendations for hospitals and healthcare systems that would be faced with a paradigm shift in the delivery of healthcare services with the advent of the Patient Protection and Affordable Care Act.

Some interesting observations by the group included the relevance of shortages within the industry. According to the report, these shortages “…will only be exacerbated by increased demand for their services by 2014. This will be due to the aging population, the addition of an estimated 32 million patients into the system as a result of the ACA, and the increasing movement of chronic disease care into the ambulatory arena. “

Several obstacles were presented in the discussion in the need to more fully integrate all healthcare providers into a new model. The new model requires that “care must be provided by inter-professional teams where work is role-based, not task based, and the team must be empowered to create effective approaches for delivering care”.

Obstacles presented included state licensing acts that restrict some practitioners full scope of practice, discipline specific desires to protect their autonomy, pipeline issues from faculty shortages, lack of education in team-based care, and caps on Medicare/Medicaid-funded residency programs.

It will be interesting to see what walls will be the first to fall if the expected population of insured Americans does grow by 32 million.