Impending doctors pay cut spurs Congress to look at shortage

By Rob Hotakainen
http://www.azstarnet.com

WASHINGTON — Congress is under pressure to remedy a national doctor shortage that could worsen on July 1, when physicians who treat Medicare patients get a 10 percent pay cut.

One-third of the nation’s active doctors — or roughly 250,000 — are over 55 and likely to retire in the next decade. And while the number of applicants to U.S. medical schools is increasing, it hasn’t kept pace with the nation’s growing population, and graduating medical students are facing rising debt loads.

A growing number of lawmakers want to stop the upcoming pay cut. And Congress is considering the Physician Shortage Elimination Act, which would spend millions to provide more scholarships for medical students and expand residency training programs throughout the nation.

“While the president’s budget does not offer any ideas for addressing the physician-payment dilemma, it is undoubtedly one of the biggest challenges that Congress faces,” said Sen. Charles Grassley of Iowa, the ranking Republican on the Senate Finance Committee.

If Congress doesn’t act soon, doctors will receive a second pay cut — 5 percent — next Jan. 1.

The shortage already has resulted in a rapid increase in the number of nurse practitioners, advanced nurses who can do the work of most primary-care physicians, and it has caused some doctors to delay their retirements.

State medical societies say there could be a huge doctor shortage by 2020, with the nation short of as many as 200,000 doctors. And in the next decade, the nation’s population is expected to grow by 24 percent, while more baby boomers will enter the Medicare system.

“It is a significant problem, which we all must address at the federal, state and local levels,” said Sen. Pat Roberts, R-Kan., who fears that if the doctor shortage worsens, elderly Americans will have the greatest difficulty getting medical care.

Doctors have stepped up their lobbying efforts on Capitol Hill. They’re seeking not only to scrap the pay cut, but also to get raises. A bill introduced by Sen. Debbie Stabenow, D-Mich., called the Save Medicare Act of 2008, would increase Medicare physician payments by 1.8 percent in 2009.

If Congress doesn’t stop the July 1 pay cut, doctors say they’ll respond by reducing staff, deferring the purchase of equipment, discontinuing nursing home visits and rural outreach, and reducing their work hours. Those findings are part of an American Medical Association survey of nearly 9,000 physicians.

Among other things, the survey found that 60 percent of the respondents said they would limit the number of new Medicare patients they treat if their pay is cut this summer.

But the doctor shortage is fueling more interest in the medical profession. While the number of medical school applicants declined from 1997 to 2002, it has risen by 7 percent since 2003, according to the Association of American Medical Colleges. The 2007 entering class was the largest in history, with nearly 18,000 first-year enrollees.

Association of American Medical Colleges President Darrell Kirch said there’s another good sign: At least 12 new medical schools are in some phase of discussion. “After failing to add new capacity for 25 years, we are now responding positively to the real growth and aging of the U.S. population,” he said.

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