Just as new patients are set to start looking for care under the Patient Protection and Affordable Care Act, providers face a startling reality: Doctor and nurse vacancies are approaching nearly 20 percent.

AMN Healthcare said the vacancy rate for physicians at hospitals is now nearing18 percent. While the vacancy rate for nurses is 17 percent, more than three times what it was in 2009.

There hasn't been a shortage of previous reports about the ongoing doctor shortage itself, but AMN's is different because it identifies an exact number of vacancies — and a startling jump from just four years prior.

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