Princess Health and Princess Health andPanel of physicians at national conference discuss future of rural primary care, how to solve doctor shortages.Princessiccia

Princess Health and Princess Health andPanel of physicians at national conference discuss future of rural primary care, how to solve doctor shortages.Princessiccia

doctor shortage physicians primary care rural health rural-urban disparities

Gusty 17:56 Add Comment

More needs to be done to address the shortage of primary-care physicians, a big problem in rural areas and much of Kentucky, according to a panel of physicians at "Rural Health Journalism 2014," Kris Hickman writes for the Association of Health Care Journalists, which sponsored the conference.

Almost half of rural U.S. counties, 44 percent, struggle with primary care physician shortages, said Andrew Bazemore, M.D., M.P.H., director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care of the American Academy of Family Physicians. According to a presentation at the 2013 Kentucky Rural Medical Educators Conference, Kentucky had a 1,287:1 primary care physician to citizen ratio, which is 557 short of the national average.

The national shortage is expected to worsen soon because almost 27 percent of those providers are older than 60, said Mark A. Richardson, M.D., dean of Oregon Health and Science's School of Medicine.

Bazemore said the medical community needs to draw more attention to the need for more primary care physicians in rural areas. He also said that for every dollar spent on health care, only six or seven cents are spent on primary care. "States facing a shortage should remember that primary care is the logical basis of any health care system," Bazemore said.

Richardson recommended that medical schools try to recruit students who have rural backgrounds because they're more likely to return to practice in rural areas. He and Bazemore agree that students who practice in rural areas should be given loan forgiveness or scholarships. "Debt prevents many people from choosing primary care," Bazemore said.

Richardson said the most important factor for where medical students end up practicing is where they completed their training. "Rural training is one of the highest predictors of a rural practice and should be required," he said. To do this, the government-imposed cap on graduate medical education spending would have to be abolished.

"Medical care is not a free market dynamic," Richardson said. "We pay for health care transactions, rather than health." (Read more)

Princess Health and Physician assistants and some doctors urge lawmakers to pass bill that could ease provider shortage in rural Kentucky.Princessiccia

Princess Health and Physician assistants and some doctors urge lawmakers to pass bill that could ease provider shortage in rural Kentucky.Princessiccia

doctor shortage health reform legislation legislature physician assistants physicians primary care state government

Gusty 17:09 Add Comment

Doctors and more than 150 physician-assistant students urged lawmakers Tuesday to pass a bill they stated involves dropping only one requirement in the law and could ease a physician shortage in Kentucky, reports Ryan Nick of cn|2's "Pure Politics."

Passage of Senate Bill 43 would repeal a law that allows physician assistants to treat patients only when a supervising physician is on site for the first 18 months after their certification. If passed, PAs would still be supervised but would be permitted to perform services in a location separate from the supervising physician, as long as that physician can be reached by phone at all times.

No other state requires PAs to have 18 months of on-site supervision. Colorado, the state with the next-longest mandate, requires supervision only for the first 1,000 hours after certification.

The bill's supporters say the burdensome supervision requirement has led to 55 out of Kentucky's 120 counties being medically underserved and has encouraged many PAs to practice in other states, reports Storm. They also say this rule needlessly complicates patient care, especially in rural areas where doctors are stretched thin, reports Melinda Beck of The Wall Street Journal.

The bill's sponsor, Sen. Tom Buford, R-Nicholasville, told Kentucky Health News that he expects the Kentucky Medical Association to seek some changes in the bill, but also expects it to pass because Senate Republican leaders, hospitals and universities support it. "We're educating these PAs at a lot of state expense just to work in other states," he said. House Speaker Greg Stumbo, D-Prestonsburg, told Storm he sees no reason why the bill shouldn't pass. Sen. Julie Denton, R-Louisville, chair of the Senate Health and Welfare Committee, told KHN that she supports the bill.

PAs are expected to be in even greater demand when the health-care reform law brings hundreds of thousands of Kentuckians into the health-insurance system. Beck notes the state is expected to face a greater shortage of physicians, particularly in primary care and rural areas. Buford said, "We're going to provide all this health care for everybody, and there's nobody to go see." For more from cn|2, including video interviews, click here.

Princess Health and Hopkinsville paper examines doctor shortage, reasons for it.Princessiccia

Princess Health and Hopkinsville paper examines doctor shortage, reasons for it.Princessiccia

doctor shortage doctors health care access health reform Patient Protection and Affordable Care Act primary care rural health

Gusty 11:35 Add Comment

Albert Delaney waits for his wife Agnes in Hopkinsville.
(Photo by Kentucky New Era's Tom Kane)

Nick Tabor of the Kentucky New Era examines Christian County's doctor shortage, with the area averaging just one primary care physician for every 2,000 people. It's the latest health story in the small daily newspaper, which is committed to quality health reporting.

The shortage creates problems for residents, who must either travel to another area to see a doctor or go without preventive services because there is no one to see until serious illness occurs. When that happens, that "puts an undue burden" on the local hospital's emergency room.

The shortage is affected by the fact that "primary care physicians, which rural areas need in higher volumers than specialists, are entering the job market at alarmingly low rates," Tabor reports. "More medical students are becoming specialists, as these jobs promise better salaries and hours." Secondly, it is difficult to recruit doctors to rural areas. "Little old Hopkinsville is up against Boston and Chicago and all of these bigger cities," said Teresa Bowers, Jennie Stuart Medical Center's physician recruitment director. "They're not throwing darts at a map and saying, 'I'm going to Hopkinsville.'"

The problem is not a new one. A 2007 report by the Kentucky Institute of Medicine shows there have been shortage issues for decades. "Even if all the barriers that have prevented a sufficient and well-dispersed supply of physicians were suddenly to disappear, the task of recruiting and educating an ample cohort of doctors would take years to accomplish," it reads.

The problem is liken to worsen, however, if the federal health-reform law is upheld by the U.S. Supreme Court, as 30 million more Americans will have insurance to see the doctor. A recent report found medical school enrollment is up by 30 percent, but more residency placements are needed to accommodate the influx. (Read more)

Princess Health and Serious shortage of primary-care physicians expected in Louisville.Princessiccia

Princess Health and Serious shortage of primary-care physicians expected in Louisville.Princessiccia

doctor shortage primary care

Gusty 08:14 Add Comment

An aging population, a high number of doctors getting ready to retire, and medical students opting to specialize for better pay and hours are all factors contributing to an expected shortage in primary-care doctors in Louisville.

"By 2020, Jefferson County will need 455 new primary-care doctors � almost as many as the number that work in local medical practices now," reports Patrick Howington for The Courier-Journal. (C-J photo by Matt Stone)

"We see a real workforce crisis in the future � in the immediate future," said Bill Wagner, executive director of Family Health Centers, a group of community clinics that serve low-income residents.

One survey of local physicians found about a third of doctors are 56 or older and are planning to retire within 10 years. Couple that statistic with the fact that the number of American medical-school seniors who entered family-medicine residencies fell from 17 percent in 1997 to 8 percent last year, Association of American Medical Colleges figures show. Part of the reason for the drop is the comparatively low salaries primary care physicians make. On average, they are paid as little as half as much as specialists, such as radiologists and invasive cardiologists.

Though doctor shortages have typically been seen as a rural problem, that's not so anymore. "No matter where you're talking about, we clearly have an aging primary care workforce," because primary care has been "so unpopular," said Dan Varga, chief medical officer of Kentucky's St. Joseph hospitals and a former Louisville internist. (Read more)