Florida doctors’ shortage trend only to worsen, report reveals

Liz Freeman
http://www.naplesnews.com

NAPLES — Many physicians in Florida plan to make cuts to their practices in the next five years and another group of physicians have already done so, according to findings of a first-ever report on the physician work force by the state Department of Health.

Of 21,610 physicians actively practicing in the state who responded to the survey, 13 percent, or 2,765 physicians, said they plan to significantly reduce or leave their practices in the next five years, the state’s Physician Workforce report released Tuesday shows.

Another 11 percent of physicians who take emergency room calls said they have reduced the number of hours they work in a hospital emergency room over the past two years.

“The report reinforces what we have known anecdotally for years,� said Jessica Swanson, program director with the state health department who worked on the project.

“Florida follows similar national trends that primary care physicians and young residents are going into specialties where they don’t want emergency room calls or extended hours.�

The survey involved half of the state’s medical doctors who renewed their licenses earlier this year and all osteopathic physicians who renewed licenses this year. The other half of medical doctors completed a voluntary survey last year at license renewal time but those 2007 results were not tallied with this year’s findings, Swanson said.

With respect to age range, 36 percent of Florida’s doctors are 25 to 45 years of age, evidence that a lot of the state’s physicians are older, she said. Citing another source, the American Association of Medical Colleges, says 25 percent of the state’s doctors, or 6,849 physicians, are 60 and older, she said.

Dr. Joseph Gauta, an obstetrician/gynecologist and president of the Collier County Medical Society, said there were no surprises in the study but it is useful for getting attention to long-standing problems of physician shortages and doctors not going into specialties that mean emergency room call.

“Physicians have been crying foul over the shortage of physicians,� he said, adding that he took part in the survey and thought the questions were on target.

When it comes to his field, only 40 percent of the respondents, or 554 OB/GYN’s, still deliver babies and another 18 percent, or 80 doctors, said they are considering dropping obstetrics in the next two years, according to the findings.

That 14 percent may not seem like a lot, but Gauta said it has to be looked at in the context that already 40 percent of his colleagues have already stopped delivering babies. The number is a reflection of exorbitant medical malpractice premiums that OB/GYN’s faced a few years ago which forced many to drop deliveries, he said.

Some OB/GYN’s had premiums in the range of $200,000 for $250,000 in coverage a few years ago, but now premiums are going down to the $45,000 to $80,000 range but still too high, Gauta said.

Within the top four specialty categories, 15 percent of Florida doctors surveyed are in family medicine and 13 percent are internists, while 13 percent reported different medical specialities and 12 percent reported they were in surgical specialties.

When it comes to emergency-room call, the workforce study found that only 31 percent, or 6,758 doctors, are taking emergency-room call.

The study came about after the Florida Legislature in recent years realized a physician shortage was ongoing and destined to worsen without action to increase residency training slots in the state and the need to develop strategies to recruit and retain physicians.

Dr. Ana M. Viamonte Ros, the state’s surgeon general, created an Healthcare Practitioner Ad Hoc Committee earlier this year to come up with ways to accomplish the goals, tapping people from health-care arenas that are impacted by the physician shortage.

“We have a very collaborative effort happening here,� Swanson, of the health department, said of the ad hoc group. Still, with the state’s budget deficit of $2.3 billion and a special session called for early January, Swanson acknowledged that creating new medical school openings and residency slots, the latter of which are funded by the federal government’s equally strapped Medicare program, isn’t likely to be a top priority.

At the same time, Gov. Charlie Crist has promoted health care initiatives and when the economy sours, more people rely on public health programs to get medical care, Swanson said.

“I don’t think we can push it too far away,� she said.

Swanson said Florida ranks 43th in the nation for its residency slots, with a rate of 16.9 residency slots for every 100,000 in population. By comparison, New York state has the most with 81 residency positions for 100,000 in population.

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