FOR IMMEDIATE RELEASE: January 7, 2008, 2 p.m.
Contact: Nancy Fiedler or Jessica
Ronan, MHA, 410-379-6200 or
443-878-7986
Martin
Wasserman, MedChi, 410-539-0872, ext. 312
MARYLAND HIT BY PHYSICIAN SHORTAGE
Silent Crisis
Imperils Access to Many Medical Specialties
A new comprehensive study of Maryland’s physician workforce shows that the state has a growing shortage of doctors in clinical practice, which could become dire for patients, especially those in need of medical specialists.
“It is a silent crisis that grows in intensity every day,” Maryland Hospital Association President Cal Pierson said. “If this shortage is not addressed promptly, patient care and access to care will suffer.”
The study conducted for the Maryland Hospital Association, and cosponsored by MedChi, the Maryland State Medical Society, found that overall, Maryland is 16% below the national average for the number of physicians in clinical practice. The most severe problems occur in rural parts of the state and will worsen by 2015, based on the study’s findings.
The widest statewide gaps are in primary care, emergency medicine, anesthesiology, hematology/oncology, thoracic surgery and vascular surgery, psychiatry, and dermatology. The study also finds Maryland has only a borderline supply of orthopedic surgeons.
The situation in Southern Maryland, Western Maryland, and the Eastern Shore is the most alarming. All three regions fall significantly below national levels in currently practicing physicians. Southern Maryland at present has critical shortages in 25 of the 30 physician categories (83.3%); Western Maryland 20 of 30 (66.7%) and the Eastern Shore 18 of 30 (60%).
Hospitals throughout the state report difficulty in finding medical specialists to cover patient needs and support their Emergency Departments. Also, the study indicates there will be future shortages in all pediatric specialties, except Neonatology, and a projected statewide shortage in Diagnostic Radiology.
Unless state leaders take steps to address this situation, Pierson said, patients soon may not be able to find the physicians they need, particularly in regions where there are a dwindling number of medical specialists.
“More patients will have to rely on already crowded Emergency Departments, for even minor ailments,” according to the MHA president. Further, “ERs will need to divert patients to other — often more distant — hospitals in order to assure the patient is seen by the appropriate specialist — at a cost to the patient’s care.”
The study calls for a number of legislative remedies including a) higher physician fees so Maryland is competitive nationally, and b) a state loan forgiveness program that will draw young physicians to regions most in need.
“We must develop incentives to encourage physicians to see Maryland as ‘physician friendly’ and to encourage them to practice in the state’s rural areas and specialty areas with the greatest shortages,” said MedChi Executive Director Martin Wasserman, M.D. “We can’t afford to wait. We must retain our current physicians and residents in training and recruit new physicians to practice in our state.”
Robert Barish, M.D., Vice Dean for Clinical Affairs of the University of Maryland School of Medicine, who chaired the Steering Committee that supervised the study, pointed out that one of the reasons for these shortages is an aging physician workforce.
In Maryland, 9.9% of clinical physicians are 65 years or older and 33.4% of them are 55 years or older. (The largest concentration of older physicians occurs near Washington, D.C., in the Montgomery/Prince George’s Counties Capital Region.)
Retirements in specialty surgical categories are particularly alarming. One-quarter (25%) of the surgical workforce is 60 years or older. By 2015, 32% of the current workforce is expected to retire. The current supply of general surgeons statewide now only meets 90% of what is needed; by 2015, the supply of surgeons is expected to shrink even further to 80% of what is needed statewide. Also by 2015, the supply of thoracic surgeons will be only half of what is necessary to meet demand.
“The number of residents trained at Maryland’s hospitals who opt to practice in-state is insufficient to make up for this wave of retirements,” Dr. Barish said. Indeed, residency program directors indicate that the 52% of residents who now go on to practice in Maryland could fall to as low as 25% by 2015. Not nearly enough clinical practitioners will be moving into Maryland to offset these factors, the study concludes.
“We must act now, to educate more physicians, and concurrently to increase the number of funded residency positions,” said Dr. Barish. “It will take until 2022 to have a meaningful impact on increasing the supply of fully-qualified clinical physicians. We can’t afford to wait.”
“Maryland’s physician shortage impacts all of us,” MedChi’s Dr. Wasserman said. “For that reason our elected leaders need to take bold steps to change this situation before the state’s citizens find themselves without the appropriate services of a medical specialist when an emergency arises.”
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About the Maryland Physician Workforce Study
Spurred by reports of projected national shortages in physician supply and specific concerns about the professional environment in Maryland, the Maryland Hospital Association (MHA) invited MedChi, the Maryland State Medical Society, to join them in undertaking a comprehensive examination of the physician workforce. A steering committee was formed that included physician, hospital, and state agency representation.
The study specifically looks at the supply of physicians providing direct clinical services to patients in the state. The baseline picture looks at the current supply of clinical physicians along with projections for future supply through 2015, and compares this to projected requirements for physicians involved in direct clinical care in order to identify actual or potential shortages. In addition, the study projects supply at regional levels and by all key physician specialties.
The comprehensive study conducted by Boucher & Associates included a quantitative analysis of physician supply using physicians licensed in Maryland along with interviews with the medical directors of 52 Maryland hospitals, interviews with a sample of residency program directors, an on-line survey of residents and fellows participating in Graduate Medical Education (GME) programs in the state, an on-line survey of primary care providers in the state, and a written survey of specialists distributed by MedChi specialty societies.
About the Maryland Hospital Association
MHA is the advocate for Maryland hospitals, health systems, and their patients before legislative and regulatory bodies. Its membership is comprised of community and teaching hospitals, health systems, specialty hospitals, veterans hospitals, and long-term care facilities.
About MedChi
MedChi, The Maryland State Medical Society, is a non-profit membership association of Maryland physicians. Its membership of over 7,000 represents nearly two-thirds of all practicing physicians in the state. Its mission is to serve as Maryland's foremost advocate and resource for physicians, their patients, and the public health.
