Mary Wakefield: Health Resources and Services Administrator.

• Position: FOR THE RECORD - Interview

"I come from the heartland where the creative use of limited health care resources is just the way we do business."

Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.

STATE LEGISLATURES: Is there a shortage of health care providers in our future?

Dr. MARY WAKEFIELD: The Health Resources and Services Administration recently released a report projecting a shortage of about 20,400 primary care physicians in 2020. The overall growth in the U.S. population and the aging of the U.S. population are increasing the demand for health care services. And, to a far lesser extent, but still important, more people having health insurance coverage will also increase demand. Likely this will be lessened as primary care nurse practitioners and physician assistants are more fully integrated into health care delivery. Of course, national data masks substantial distribution shortages that exist across the country.

SL: What is the federal government doing about the possible shortages?

MW: The president's budget for fiscal year 2015 supports increasing the number of primary care physicians by 13,000 by 2020 and expanding the National Health Service Corps from an annual field strength of 8,900 to 15,000. The president's budget request also contains provisions to expand the number of primary care providers and place them in communities most in need of them. Decades of data tell us that strong primary care improves health and decreases use of expensive emergency rooms and hospitalizations.

SL: What can state policymakers do to address future shortages?

MW: One of the nation's best tools for addressing maldistribution of our primary care workforce is the National Health Service Corps. This program recruits and retains primary care providers--doctors, dentists, psychologists and others--to work in underserved communities by offering scholarships or loan repayments for their medical educational costs. The...