Severe Dearth of Physicians for land

[Guest guest]

Severe Dearth of Doctors Forecast for land By Levine

Washington Post Staff Writer Tuesday, January 8, 2008; Page B01

Much of land faces a doctor shortage that could become severe by

2015, forcing patients to wait longer for appointments, search for

specialists and turn more frequently to emergency rooms for help,

according to a report released yesterday.

Southern land is expected to be hit hardest -- the region lacks

physicians in most categories now -- with Western land and the

Eastern Shore close behind. With nearly one in three specialists older

than 60, Montgomery and Prince 's counties will confront a surge

of retirements. The two jurisdictions already count fewer general

surgery physicians and residents per 100,000 people than any area in

the state but Southern land.

The report by two state health-care groups says the impact will be

felt most acutely in overextended emergency rooms, where finding

specialists for on-call duty is difficult today. It urges medical and

elected leaders to take " bold steps " to attract and keep clinicians

but includes no price tag for nearly a dozen suggested actions,

including higher physician fees and incentives to draw doctors to

rural areas.

" This is an escalating crisis, " said Wasserman, executive

director of MedChi, the land State Medical Society, which

commissioned the analysis with the land Hospital Association.

" We've reached a turning point. "

The groups are the latest to warn of serious trouble because of a

shortage of health professionals. This fall, a coalition of hospital

executives and nursing educators predicted a shortfall of 10,000

nurses within a decade and proposed spending $59 million to expand

local training programs.

The issues are not confined to land. A Northern Virginia alliance

of hospitals and colleges is halfway through a four-year initiative to

increase the ranks of nurses and other health-care workers and fill

thousands of positions that by 2020 are projected to go wanting

without action. By that same year, the American Medical Association

foresees a national shortfall of 20,000 doctors. Cities with academic

medical centers, such as the District, will probably fare better.

The pressures stem from an aging population and physician workforce,

little growth in medical education programs and rising demand for

health care. In such places as Southern land, booming development

exacerbates the need.

St. 's, and Calvert counties have only 44.4 primary care

physicians per 100,000 residents, well below the state average of 57.

They have barely four psychiatrists for every 100,000 people, and the

report identifies critical shortages there in all other specialties

but ophthalmology, urology, neurology and allergy. By 2015, only

neurology could have adequate supply to meet demand.

St. 's Hospital is spending millions of dollars to pay doctors and

surgeons specifically to answer emergency calls and ensure care will

be available. It added midwives to deliver babies and a " director of

physician services " to help retain existing staff. School officials,

the Chamber of Commerce and business executives all get involved in

recruiting new doctors. " It is very challenging, " said Wray,

the hospital's chief executive.

Statewide, the report says, there are 16 percent fewer doctors in

clinical practice than the national per capita average. Some of the

biggest gaps are in primary care, emergency medicine,

hematology/oncology and thoracic and vascular surgery. The only part

of land in decent shape now and for the future is the central

region -- and Anne Arundel counties and the Baltimore area

north to the Pennsylvania border.

" Unless medical and political leaders find ways to reduce physician

shortages, patient care will suffer, " predicts the report by the New

York firm Boucher & amp; Associates. Its analysts interviewed

administrators at 52 land hospitals and several medical residency

program directors and surveyed primary care and specialty care physicians.

Too few physicians are moving in from other states, and only half of

medical residents remain in land after finishing their training.

If that number of residents starts to fall, as some educators fear,

the anticipated shortages will worsen.

" The physician gaps are really going to compromise landers' access

to health care, " said Cal Pierson, the hospital association's president.

The report, presented last month to the Governor's Task Force on

Health Care Access and Reimbursement, says land's physician

reimbursement rates and malpractice insurance costs must become

competitive with those of other states. It recommends lawmakers

forgive educational loans for medical graduates who practice in rural

areas and calls for regional collaboration in emergency care.

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