Primary care doctors in short supply across US

Graduates choosing ‘more lucrative’ specialty practices, hospital says

By Owen Boss

GARDNER — Massachusetts Medical Society’s annual Physician Workforce Study released Wednesday showed the number of physician specialties found to be in short supply has doubled to a total of 12 in just three years, a statistic that has many area hospitals looking for a solution. Three specialties — oncology, neurology and dermatology — examined for the first time in this year’s study, were declared in shortages for the first time. The other nine areas seeing shortages are emergency medicine, general surgery, neurosurgery, orthopedics, psychiatry, urology, vascular surgery, internal medicine and family medicine. The study examines the state’s physician work force through surveys of practicing physicians, medical staff presidents of community hospitals, department chiefs in teaching hospitals, medical groups, residency and fellowship program directors and public opinion surveys. The 2008 study is the society’s seventh annual comprehensive look at multiple aspects of the physician work force. Lorie Martiska, vice president of community relations at Heywood Hospital said the shortage can be attributed to a decrease in the number of graduate students choosing to go into primary care. “There is indeed a growing shortage of family medicine and internal medicine physicians due to a variety of factors — most notably the reduction in numbers of medical school graduates choosing primary care rather than other more lucrative specialties,” said Ms. Martiska. “More needs to be done to attract students into primary care residencies. Changes such as insurance companies offering higher levels of reimbursement for the time-consuming aspects of primary care would help.” Although the shortage is affecting hospitals nationwide, Ms. Martiska said Heywood has been able to avoid some of the problems associated with the low number of doctors by relying on their committed staff. “At Heywood we have been very fortunate to have an outstanding medical staff with doctors who have partnered with us to bring more physicians into our community,” said Ms. Martiska. “We have recently increased our compensation and benefits packages for prospective physicians to fill some particularly challenging openings. We know that we must compete on a national scale with many others seeking the same physicians.” The report’s findings lead the society to conclude that “patient demands on these specialties have outstripped supply.” Bruce Auerbach, president of the society, said the situation is limiting and delaying access to care, causing difficulty in referrals to specialists, and creating long wait times for both primary and specialty care. “Our latest analysis raises serious questions about our ability to efficiently handle the increased demand for health services for both primary and specialty care,” said Dr. Auerbach. Among the primary factors causing the shortage is the recently imposed regulations requiring state residents to have health insurance, according to Dr. Auerbach. “The success of health care reform in insuring hundreds of thousands more people is a great step forward. But it has put enormous pressure on primary care, and we now know that insurance without access to care will not result in true health care reform and that universal coverage does not equal universal access,” said Dr. Auerbach. “With more patients, an aging population and rising rates of obesity and chronic disease, demand is overwhelming supply, and our physician work force is coming under more stress and strain.” oboss@thegardnernews.com

Appeared on Page 1 on 10/13/2008 (Vol. 206 No. 242)