Rural Areas Face Physician Shortage

A report released by the Maryland Hospital Association and MedChi (the Maryland State Medical Society) recently caused a stir by illuminating the shortage of physicians in Maryland’s rural communities. The report, which noted that Maryland has currently fallen 16% below the national average for practicing physicians per capita, cites concerning statistics about the declining number of doctors in the area. As the baby boomer population heads toward retirement, so too will record numbers of physicians. In Maryland alone nearly 30% of all physicians are 55 or older and approximately 30% of surgeons are expected to retire by 2015. This retiring workforce, coupled with below-average private insurance reimbursement rates, has created a troubling scenario that will worsen if nothing is done to address it, according to Cal Pierson, President of the Maryland Hospital Association.

Maryland, however, is not the only state encountering difficulty in attracting physicians to its rural areas. Rural northwest Ohio, upstate New York, Idaho, and Washington State all face similar scenarios. These states also struggle with a retiring healthcare workforce and low insurance reimbursement rates. In addition, these rural places compete with major metropolitan areas that more readily attract young physicians. In the case of upstate New York, where physicians are often lured to warmer climates, hospitals and physician practices are seeing a significant decrease in the number of applicants for open positions.

The impact of a physician shortage may be felt not just in these states, but across the entire country. Even in states teeming with medical schools, such as Massachusetts, physician numbers are at risk. According to the Massachusetts Medical Society, the rising cost of liability insurance coupled with demanding administrative burdens caused up to 37% of physicians to consider leaving the profession altogether. Nationwide, as the population ages, the need for medical care will increase at just the time hundreds of physicians retire, causing concern about the effect fewer doctors will have on the healthcare industry. Patients may have to increasingly rely on crowded emergency departments for care. Already health care consumers in Maryland and other states face difficulty finding physicians who will take new patients. Those that do encounter long wait lists for appointments.

Clearly these statistics raise the question of how to best address the shortage. The American Academy of Medical Colleges (AAMC) has called upon medical schools to increase enrollment 30% by 2015 (an annual increase of 5,000 students). More locally, legislators in Maryland will consider a bill to increase physician reimbursement rates, develop state loan forgiveness programs for physicians who practice in rural areas, and lower caps on medical malpractice compensation. Lawmakers in Washington State are also looking to create incentives for physicians to stay. Nationally, increased efforts at preventive care and public health education may lessen some of the demand. And although having more doctors does not ensure better healthcare, increasing the numbers will at least guarantee access, which some people fear they will no longer have.