Study: Physician shortage means Md.'s insurance, malpractice systems must change

KAREN BUCKELEW
Daily Record Business Writer

Maryland’s doctors and hospitals are calling for change in the state’s health insurance and medical malpractice systems, pointing to a new study showing a growing shortage of physicians.

The state has 16 percent fewer practicing doctors than the national average, according to the study released Monday from the Maryland Hospital Association and MedChi, the Maryland doctor’s association.

The problem, more severe in the rural regions of Eastern, Western and Southern Maryland, is projected to worsen as existing doctors retire and insufficient numbers of medical students graduate to succeed them.

It is an issue policy makers must attack from all sides, according to the recommendations of the report, the first to study the physician work force in Maryland.

“Our study reveals Maryland already has a silent and growing crisis,� Dr. Martin P. Wasserman, MedChi’s executive director, said as he unveiled the study at the University of Maryland School of Medicine’s historic flagship building, Davidge Hall, in West Baltimore.

The low rates private insurers pay Maryland doctors and the high premiums malpractice insurers charge physicians has made the state an undesirable home for physicians, said Wasserman and Cal Pierson, Maryland Hospital Association president.

“We have to have a better environment for physicians in Maryland than competing states,� said Pierson.

The number of doctors practicing in Maryland is 10,227, according to the report, which broke down its analysis into five different regions of the state and 30 different physician specialties.

The worst shortages were found in primary care, emergency medicine, anesthesiology, hematology/oncology, thoracic surgery, vascular surgery, psychiatry and dermatology.

In Southern Maryland, the study found critical shortages in 25 of the 30 physician specialties. In Western Maryland, 20 of the specialties were significantly understaffed, and on the Eastern Shore, the number was 18.

More medical students are needed to staunch the developing crisis — and they’re needed now, since they won’t be able to practice until 2022 — and Maryland needs to recruit more out-of-state doctors, said Dr. Robert A. Barish, chair of the steering committee that developed the study and the vice dean for clinical affairs at the University of Maryland medical school.

Maryland ranks lower than the 25th percentile nationwide in the rates insurers pay physicians for their services, according to MedChi. At the same time, the malpractice insurer that covers 70 percent of the state’s doctors has raised its premiums as much as 33 percent in recent years.

Key changes could include creating a pay schedule for doctors that would apply to health insurers statewide, Wasserman said.

It also could include caps on damages in malpractice cases, a move that could lower the cost of malpractice insurance. Such caps typically are strongly opposed by trial lawyers and patient advocates.

The report also recommends the state find a way to attract more doctors to the rural regions of the state that seem the hardest hit by the physician shortage.

Any policy solutions, however, likely will wait for the June release of the report of the Maryland Task Force on Health Care Access and Reimbursement, a team that lawmakers charged with examining the payments physicians earn from insurers.
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