Opinion: Doctor shortage

http://www.bradenton.com

Floridians have been served notice again that the state’s doctor shortage looms large over our health care system.

Just a few days after the president of the Florida Medical Association sounded a dire warning about the “critical” physician deficit, Bayfront Medical Center in St. Petersburg was forced to stop taking trauma patients due to a lack of neurosurgeons on emergency call. Those patients were diverted to Tampa hospitals.

Not only did Bayfront suspend its state designation as a trauma center for two full days late last month, it was the third time the unit closed in 10 days.

This is especially troubling for Manatee County residents because Bayfront serves as one of our trauma centers, treating our victims of violence, serious accidents and other near-fatal injuries.

Trauma and other specialists are in too short a supply statewide, and that endangers public health.

As president of the Florida Medical Association, Dr. Karl M. Altenburger knows the bleak situation all too well. The retired allergy specialist from Ocala discussed the dilemma with Bradenton Herald medical reporter Donna Wright while here recently.

He blamed several factors for the doctor shortage: the perennial Medicare and Medicaid budget cuts and the low reimbursement rates in the state; the high cost of medical malpractice insurance and the lack of significant tort reform; the aging population of physicians and the inability to recruit young doctors; and the state’s lack of medical training, including internships as well as residency and fellowship programs.

Only the politicians in Tallahassee and Washington can change the course of this critical physician shortage.

Manatee doctors sat down with Rep. Vern Buchanan, R-Sarasota, early last month to ask him to make Florida a pilot site for Medicare reform. President Bush’s call for $196 billion in Medicare reductions in his 2009 budget does not bode well for a state with a large Medicare population.

That big number of Medicare patients makes recruitment of young doctors tough, because the reimbursement rates for Manatee County are among the lowest in the state.

And Florida physicians pay more for medical malpractice insurance than doctors in most states, according to Altenburger.

It doesn’t take a genius to see that the state’s lower physician income and higher expenses equal a doctor shortage.

And the state ranks 46th in the nation for the number of graduate medical education programs, another disincentive for attracting and keeping young doctors.

Tort reform, though, stands atop Altenburger’s list of physician problems – particularly Florida’s three strikes amendment, unique in the nation. This helps explain the neurosurgeon shortage at Bayfront Medical Center as well.

As Altenburger explains, the law mandates that a doctor lose his license to practice medicine after the third malpractice judgment against him. Physicians such as neurosurgeons treat high-risk patients with poor odds of recovery and often battle lawsuits. Every state brings up this law in order to recruit doctors away from Florida.

And we’re left with a critical shortage.

Every one of us should be concerned. But what can we do?

We urge you to contact our state lawmakers to sound the alarm and to request meaningful tort reform, more medical educational programs and adjustments in Medicaid and Medicare reimbursement rates.

We urge you to contact our senators, Bill Nelson and Mel Martinez, who are supporting a bill in Congress to boost funding for more graduate medical programs in states that rank on the lower end for those – like Florida. We support that measure.

And we urge you to contact all of our politicians on the Medicaid and Medicare issue.

It’s for your health.

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