To North Carolina's health

North Carolina, heal thyself. That’s a depressingly fitting admonition in many rural (and some urbanized) parts of the state, where physicians are in short supply. Thanks to the N.C. Institute of Medicine, the legislature has a decent road map for improving the situation.

A number of state agencies and health nonprofits have made the point that North Carolinians risk their health and lives because they have no or too few physicians practicing near their communities. For example, some pregnant women must travel long distances for prenatal care and to deliver their babies, a fact that might contribute to the state’s worrisome infant mortality rate.

North Carolina is projected to face a doctor shortage over the next 20 years, due to the number of new residents flocking to the state, an aging population and an increase in chronic diseases. This state still is largely rural, and doctors, particularly specialists, are less likely to be able to make an adequate living when their base of patients is thinly spread.

The institute, an advisory board of 100 appointed by Governor Easley, says with some logic that the legislature should expand the number of medical school seats, or alternatively, open a new school. The approach taken by East Carolina University’s medical school to training doctors for the state’s underserved areas certainly should be studied as a model. The institute also recommends efforts to market the positive aspects of the state’s rural areas to attract more practitioners.

Legislators should be cautious with a recommendation to help pay doctors’ malpractice insurance. High premiums in some specialties, such as obstetrics, do deter some doctors from providing those services. The state insurance commissioner may need to investigate whether malpractice insurance costs have been unduly inflated. But in general, the institute’s proposals seem healthy in light of a tough problem facing the state.
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