OCEAN CITY – Though the need for more doctors in this country is evident, fixing the healthcare system as a whole might be more complicated than just merely more hands on deck.
Last week’s article touched on the challenges facing local healthcare workers and addressed some of the problems they are facing such as physician shortages, Maryland being amongst the worst in the country for doctor reimbursement and the struggles to recruit and retain physicians to this area.
Dr. Thomas Lawrence, Chief Medical Officer at Peninsula Regional Medical Center in Salisbury, addressed some of the ways to deal with not only the doctor shortages both locally and nationally, but also how to perhaps remedy a “sickness” in the healthcare system itself.
“From a manpower perspective, there’s a real challenge for the delivery of healthcare in this country,” he said. “We’ve all been to parties where someone said that it took them three months to actually get in to see a doctor. That might seem like a bargain in a few years if we don’t find a way to fix this.”
Lawrence said that though the number of physicians at PRMC (which is approximately 300) “is meeting the demands of patients pretty comfortably”, he said that the need for doctors in the area’s five counties is about 35 per year and around 100 within the next five years.
“There’s no place in the country that isn’t trying to recruit doctors in just about every specialty possible. There’s hospitals in California that are trying to recruit about 700 doctors, so in comparison, we don’t need that many based on our size, but finding a 100 doctors to practice in this area within the next five years is quite a challenge,” he said.
Simply hiring more doctors might seem like an easy task, but there are less of those to go around, reports say. Fewer students are enrolling in medical schools, and the time it takes to train a doctor to the point where they are ready to practice medicine on their own, is not exactly a quick turnaround.
“Most students are leaving medical school with $150,000-$4250,000 in debt. Then if you factor in the fact that it takes four years of med school, plus another three years of residency, it takes about seven years to train someone to practice medicine, Lawrence said. “Yet, it’s the post-graduate programs that need to be funded better and increase their numbers as if we don’t fix that and train doctors in specialties, we are just rearranging chairs on the deck.”
Lawrence said that the days of small private practice doctor’s offices are “pretty much a thing of the past”, and cited that the costs so greatly outweighing the profits that it leads doctors to more urbanized areas and certainly to states that have a higher reimbursement rate than Maryland.
“Expenses are way too high and the profits are way too low. At the end of the day, if we don’t fix the reimbursement policy, we face a recruitment challenge that is almost impossible unless there’s a fundamental change,” he said. “For too long, it’s been the doctors vs. the insurance companies, and the insurance companies are not suffering any losses.”
A recent study by the New England Journal of Medicine stated that the proverbial battle between healthcare workers and insurance companies is incredibly lopsided, as insurance companies pick and choose whom to care by “cherrypicking” the young and healthy, and have the ability to deny care to anyone that isn’t. The study also reiterated a pretty well known fact that Americans spend more per person on healthcare premiums than any other country on the planet by a long shot.
Lawrence agreed with the January report by the Maryland Hospital Association (MHA) projecting a “perfect storm” for the medical industry as doctors are harder to come by, more people are uninsured and lack a primary care physician and the country’s population is getting older and sicker as the “baby boomer” generation reaches retirement age in 2011.
Roger Blackwell, Ph.D, and professor of marketing at Ohio State University, likened the American health care system to the retail industry, pointing out the success of companies that offer similar products at a lesser price.
“Hospitals and physicians are retailers facing the same problem as retailers that sell everything from computers to clothes,” he said. “The same solutions that allowed Wal-Mart and Target to triumph over traditional department stores will lead to the triumph of innovative new forms of healthcare institutions. General hospitals that fail to understand this will feel the pain of polarity, and suffer the inevitable fate, like Montgomery Ward and K-Mart did.”
Lawrence said that some quick fix remedies for the doctor shortage could be to ease the visa requirements allowing foreign doctors to practice medicine in this country as well as granting some loan forgiveness for doctors as they leave medical school.
“We’ve been living with a failed health care policy for some time, and we face the same challenges in rural and urban areas and that’s to provide the best healthcare we can for those who need it,” said Lawrence.
Though the industry looks grim, the occupation itself looks bright according to Lawrence.
“From a career standpoint, the healthcare profession has never looked brighter,” he said.