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June 6, 2014

Bassett official: Doctor shortage isn't easily solved

By Jessica Reynolds Staff Writer
The Daily Star

---- — New legislation seeking to ease the shortage of primary care doctors in upstate New York may not necessarily take care of the problem, a Bassett Medical Center administrator said Thursday.

During a conference call with reporters on Wednesday, Sen. Charles Schumer, D-N.Y., said he’s pushing a new bill called the Resident Physician Shortage Act, which would address the shortage.

“(Primary care physicians) provide us with our annual checkup, they help our children grow into healthy young adults, and they are often the first phone call we make when we are feeling sick,” Schumer said. 

According to a study by the Kaiser Family Foundation, New York is only meeting 40 percent of its primary-care needs, one of the lowest rates in the country. Data from the federal Health Resources and Services Administration say New York needs more than 1,100 additional primary care physicians to reverse the present shortage.

Delaware, Otsego, Chenango and Schoharie counties are feeling the pinch as well, according to a chart from the SUNY Center for Health Workforce Studies. 

From 2010 to 2013, doctor availability decreased by 27 percent in Schoharie County, 20 percent in Chenango County, 11 percent in Delaware County and 10 percent in Otsego County, according to the research center.

Schumer said the Resident Physician Shortage Act, if passed, would alleviate the problem by prioritizing primary-care training and increasing the number of Medicare-supported physician training residency spots by 15,000 over the next few years.

The legislation would place a special emphasis on giving more residency slots to hospitals that serve rural areas and are experiencing significant physician shortages, Schumer said.

But the new legislation may not fully take care of the problem, according to Bassett’s director of medical education, Dr. James Dalton. 

Pumping more residency spots into the pipeline will only fix part of the problem, Dalton said, but many uncertainties will remain. It will depend on the overall direction in which health care financing goes, he said.

The main reason primary care physician spots are not being filled, especially in upstate New York, is because they’re at the low end of the compensation spectrum, Dalton said. Doctors frequently choose to go into more lucrative fields or move to urban areas. That’s the root of the problem. However, that aspect often gets overlooked, he said.

“It’s a big deal. If you’re a 25- or 28-year-old just out of medical school, and you’ve deferred your earning during that time — plus you’re at the age where you might be thinking of starting a family — and now you have more than $300,000 in student loan debt? That’s daunting,” Dalton said. “A primary-care job is not going to meet that need as easily as a higher-paying job.”

An effective way to attract more primary care physicians would be to increase their salaries, Dalton said. This would provide greater incentive for new doctors to stay in primary care.

It’s important to note that, of the four surrounding counties, Otsego County’s ratio of physicians per 100,000 people was almost double the state average in 2013, said Dalton. Also, the percentage that number has decreased is less than in the other three counties.

“We do better than the average because we have a strong network,” Dalton said, “and because of fairly aggressive recruiters. We’re better situated than most, but the situation is still not great. The truth is, there are a lot of doctors retiring and not a lot coming in from the other end.”