Health care crisis looming as more doctors retire, patients increase

By Owen Boss

State hospitals and medical practices are facing a primary care physician shortage crisis, say health officials. The number of current primary care physicians who are retiring is rising, as is the number of citizens enrolled in the state’s health care coverage programs, causing the ratio of patients to practicing physicians to rise, which concerns officials. As a result, Congress is working on legislation that will fund incentives to attract recent medical school graduates to operate in underserved locations across the state. According to a statement made at a recent discussion on the issue, Dr. Peter McConarty of the CHC Family Health Center said that preliminary reports show that the physician to patient ratio is 4,100 to 1 in the Fitchburg area, which is more than double the expectations of a primary care physician. The cause of the crisis can be linked to the large number of current physicians retiring and an increase in medical students choosing to practice in specialty care, because they can work better or fewer hours and make more money, said Dr. Beth Kurtz Mazck, medical director at the family health center. “Thirty years ago there was probably a 30 percent salary differential in specialty medicine versus primary care,” said Ms. Mazyck at a recent forum held in Fitchburg. “Today that differential can be closer to 300 percent.” Many officials say the only solution to this increasing demand for primary care physicians is to create state-funded programs to assist medical school graduates in paying off their remaining school loans. Those students already interested in primary care will benefit from these programs, said John DeMalia, executive director of the community health center. However, Mr. Demalia doubts the program will influence people to switch career choices. “I don’t think that as a result of these programs you’d have someone who is interested in specialty medicine switching to primary care,” said Mr. DeMalia. “Many of these doctors are going into the field because they want to be primary care physicians. When they can see these programs are going to pay off their loans, even if it is only $25,000 a year, after taxes that number really adds up,” he said. “These programs will still allow the physician to do what their heart is telling them to do which is go into primary care, it will just make the decision an easier one to make,” he added. At a recent forum held in Fitchburg, Congressman John W. Olver, D-Amherst, voiced his concern regarding the lack of physicians available. Mr. Olver said that although there have been several plans put in place aimed at solving this particular problem, there is a demand for the creation of a solid plan and a stop to what he called “patchwork fixes.” Mr. Olver is currently pushing for pending legislation that would begin to resolve many critical issues related to the shortage of primary care physicians. Senate Bill 2526 calls for legislation to promote cost containment, transparency and efficiency in the delivery of quality health care. Senate Bill 1078 would create a 23-member task force to study issues relating to the shortage of health care workers including physicians and other health care professionals. House Bill 4514 is a proposed act relative to financial incentives for primary care physician recruitment that involves two steps. The first is to establish a physician loan repayment program in the Board of Higher Education to assist medical school gradates specializing in primary care that make a commitment to practice in underserved areas of the state. The second is to establish a Healthcare Workforce Council with the Departments of Labor and Workforce Development to assess the needs of the physician and nursing work forces. Currently working its way through the U.S. Senate and House, the bill in favor of the loan repayment delegates that the awards granted to graduating medical school students will be made by the Massachusetts League of Community Health Centers to applicants in the form of forgivable loans. These loans can be up to $25,000 a year for up to three years, for a maximum total of $75,000. Exact amounts may end up being less based upon the applicant’s outstanding student loan indebtness and other critera. Kerin O’Toole, public relations director at the Community Health Centers league, said that the bill is expected to come before the full Senate April 17 and it will then move to the House for a vote. According to Ms. O’Toole, the funds provided would be funded through a unique public-private partnership that includes Bank of America, Commonwealth of Massachusetts, Neighborhood Health Plan, Partners Healthcare and Blue Cross Blue Shield Foundation of Massachusetts. oboss@thegardnernews.com

Appeared on Page 1 on 4/15/2008 (Vol. 206 No. 90)