Solving The Mystery Of The Missing Doctors

By JACK JAWITZ
http://www2.tbo.com

Have you seen them? They used to be among us. They used to be in your neighborhoods.

We depend on them for our very life; from the day we’re born till the day we die, inclusive; and there are fewer and fewer in Florida.

I am speaking about your doctors. The Florida health care task force knows that there are 54,000 licensed physicians in Florida, and as pointed out in a recent response to an earlier column, that translates to an increase each year keeping up with the Florida population.

The numbers alone are very deceiving, however. The numbers don’t tell you that 25 percent of these licensed physicians do not even live in Florida. The numbers don’t tell you that 26 percent of the total are part-time physicians practicing less than 20 hours each week.

Additionally, some 13 percent of Florida doctors say they plan to leave the state or reduce or end their practice over the next five years. Thirty-two percent of physicians in Florida were approaching retirement age (ages 55 and over) in 2004. That leaves somewhere between 27,000 and 34,000 full-time equivalent doctors caring for 15 million Floridians, a number estimated to be 50 percent too little.

Current Department of Health data show that over half of active, licensed Florida physicians are over 50 years of age. More than 22 percent are older than 65.

Some trial attorneys will lay blame wherever they can to deflect their own involvement in the disappearance. They blame public policy in 1970, or various organizations, or blame it on national trends; but the reality is that your doctors are leaving in part because of the legal system. And I know where they are going.

Florida now has seven medical schools because the Legislature is aware of the shortage of physicians. It approved three new schools in the last five years. Florida ranks 41st in the number of medical students per capita and 46th in the per capita number of medical residents.

But neither Gov. Charlie Christ nor state lawmakers can make the new doctors stay in Florida. We can pay for medical student training at a cost of about $250,000, and they burden themselves with another $200,000 of debt only to leave Florida at the rate of 86 percent.

Florida is spending your tax dollars to train physicians for export out of Florida! A private medical school graduating 135 physicians in 2008 had only four new doctors planning to stay in Florida.

Well, as promised, I know where the doctors are going, and I will tell you why. Physicians are moving to Texas.

That’s because the Texas Legislature in 2003 passed a comprehensive package of tort reform designed to reduce the frequency of medical malpractice lawsuits, the size of malpractice payments, and physicians’ insurance premiums. In 2006 the number of applications for medical licenses in Texas is up over 30 percent from 2005.

The Texas Board of Medicine was so unprepared for this transfer of talent into their state that the processing time per licensee increased from 20 days to over six months, and they are behind in processing almost 3,000 applications. New physicians moving to Texas means more and easier access to health care for all Texans.

Florida created a surgeon general position last year whose main mission is to obtain better patient access to health care. If our surgeon general, Ana M. Viamonte Ros, M.D., could spend her time advocating for tort reform like the statesmen in Texas, we could be flooded with applications for new physicians and the access problem would solve itself.

Florida is a very doctor-unfriendly state, and our medical students and out of state colleagues know this. The doctors around the country learn this from recruiters who encourage them to go elsewhere. You will continue to hear about doctor shortages here and there, closed emergency rooms and or hospitals; long trips to deliver a baby or find a specialist.

When we the people are ready to address the issues as they have in Texas with real and comprehensive tort reform, be prepared for a migration of doctors to Florida. Your own access to health care will increase as will the rest of your neighbors. Until then, if you need a doctor, go west to Texas because that’s where the doctors are going. No matter how much they advertise that they are there for you, the lawyers can’t help when you’re having chest pain, and Texas is a long way to find a doctor.

Jack Jawitz is a physician practicing in Sun City Center.

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