story by Michael Tilley
A looming doctor shortage in the U.S. that Kyle Parker classifies as a “crisis” is one of the primary reasons the Fort Smith Regional Healthcare Foundation is planning to invest more than $58 million to build a college of osteopathic medicine in Fort Smith.
The foundation announced the project Feb. 18, along with an announcement from the Fort Chaffee Redevelopment Authority that it would donate 200 acres – valued at $4 million – to the college. Once fully operational, the college will serve about 600 students, with about 150 graduating each year. The college is also estimated to employ around 65 (full-time equivalent jobs) with an average salary of $103,000. The school is targeted to accept its first cohort of students in the fall of 2017.
Parker, chairman of the FSRHF, said Tuesday that one of the most frequent questions has been, “Will you be able to recruit students?” The answer to the question, according to Parker, is a definite, “Yes.”
He said there are about 2,500 applications for every opening in U.S. medical schools. He also said the country will have to produce more doctors to push back against a possible shortage of 140,000 doctors by 2030. That number could rise to 250,000 if the federal Affordable Health Care Act if fully implemented.
“We are in a medical crisis in the United States,” Parker told the more than 85 people who attended the Tuesday press conference.
That sense of urgency to expand medical training is also shared by the Association of American Medical Colleges. The group predicts that a shortage of 91,500 doctors by 2020, with the shortage increasing to 130,600 by 2025. Of the 91,500, the AAMC estimates a 45,400 shortage among primary doctors and a 46,100 shortage in surgeons and specialists. The group also estimates 250,000 doctors will retire by 2020.
During a Jan. 14 interview on C-SPAN, Dr. Atul Grover, chief public policy offer for the Association of American Medical Colleges, said the “silver tsunami of baby boomers” will be a big cause of physician shortages. He also said there is a “bottleneck” at the residency level, and he blamed Congress for curbing support of residency training. According to Grover, Congressional passage of the 1997 Balanced Budget Act reduced funds for residency support.
Grover said medical colleges have boosted enrollment a combined 30% since 2006, but residency openings have shown less than 1% growth. He said what Congress has “failed to do is to address a freeze on support for physician training that’s been in place now for 16 years.”
The AAMC website notes that “Medicare support of graduate medical education (GME) includes paying its share of the costs of training, as well as supporting the higher costs of critical care services, such as emergency rooms and burn units, on which communities rely. Without adequate support, the ability of teaching hospitals to provide essential patient care is threatened.”
MEDICALLY UNDERSERVED AREAS
Reports from Kaiser Health and the Pew Center also point to a shortage of doctors.
A Kaiser report notes that the federal Health Resources and Services Administration estimates that 20% of Americans – roughly 55 million – live in areas with too few primary care doctors. The agency also says that 16% of Americans have too few dentists, and 30% live in areas with not enough mental health care doctors and providers.
The Pew Report says federal government estimates are that the number of doctors will grow by 7% in the next 10 years, but the number of Americans over age 65 will grow by 36%. The nation would need more than 15,000 additional providers to meet the target ratio of one primary care practitioner for every 3,500 residents, according to federal estimates. Massachusetts, according to the Pew report, has the most primary care doctors per capita and Mississippi has the fewest.
The Pew report also notes that income may also result in fewer primary care doctors. Primary care physicians earn around $3 million less during their career than their colleagues in specialty fields.
150 TOWARD SOLVING THE PROBLEM
Parker said Tuesday that the new college of osteopathic medicine will play a small role in attempting to address the shortage.
“We’re happy to put out 150 (graduates) a year to help solve that problem,” Parker said.
He also praised area physicians and medical facility managers for working together, “despite being competitors,” to “get clinical rotations worked out” and address other issues to provide enough residency positions in the area to support the new college.
“You can’t say enough about that kind of commitment,” Parker said of the collaboration among area doctors and medical operations.