And so it goes . . .
Maryland is confronting a growing, statewide shortage of practicing primary care and subspecialty physicians, a trend that could lead to much longer waiting times in physician offices while increasing emergency room visits for minor afflictions and ailments.
The solution of “increasing the number of residency slots” isn’t going to work. Primary care residencies don’t fill anyways. The key is incentivising medical students to choose primary care, and that starts with complete loan forgiveness.
Related posts:
- Universal health care and the physician shortage
- Academia responsible for the primary care shortage?
- How to fix the primary care shortage
- Match Day comes and goes, and did medical students continue to avoid primary care?
- Primary care
- Is loan forgiveness enough to convince students to choose primary care?
- "No more primary care . . . no more forms"
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Maryland has a high cost of living compared with many other states and a high cost of practice operations, due to higher wage costs and rents. None of those feature well on the recruiting efforts. There are wide disparities in wealth in different areas of the state, with counties near Baltimore, Annapolis and Washington having among the highest per-capita incomes in the country and other counties that have typical inner-city problems and other rural areas that are typical for Appalachia.
Primary care residency slots eventually do fill with FMG’s. I don’t want to adversely characterize all FMG’s, but it is my observation that many FMG primary care physicians provide a lower quality of care but will be happy with less reimbursement. Perhaps this is the secret plan.
I agree that increasing residency slots will do nothing to increase the number of physicians choosing to practice. I spent 16 years of my youth in Maryland but left the state for school and now practice in Texas. I have never looked back. Lower taxes, progressive legal reforms, a much lower cost of living, and more plentiful blue crabs make this a no-brainer. Educational loan forgiveness is NOT anything that would attract me back. Try tort reform, lower taxes, and blue crab replenishment of course!
If you read on, there is also a shortage of specialists mentioned:
“The study found physician shortages in primary care and several subspecialties, including emergency medicine, anesthesiology, hematology/oncology, thoracic and vascular surgery, psychiatry, and dermatology….. Some emergency departments may have to close or divert patients who could otherwise be treated locally.
Medical residency program directors, meanwhile, “indicate that the 52 percent of residents who now go on to practice in Maryland could fall to as low as 25 percent by 2015,” the report says. “Not nearly enough clinical practitioners will be moving into Maryland to offset these factors.”
“The state’s physician shortage is a result of several factors, including low payment rates and the state’s medical malpractice laws. In the report, the task force members urge the state to “raise physician fees so Maryland is competitive nationally” and to “change the state’s medical liability laws so Maryland is competitive with (other) states currently attracting physicians.”
“The state also should “develop programs that encourage more residents who are training in Maryland to remain in state as clinical practitioners,” the report says.”
Maryland can’t compete effectively against Virginia, North Carolina, South Carolina let alone other states not on the central and southern Atlantic seaboard. Living costs, practice costs, crowding and congestion, litigation environmment and the willingness of hospitals elsewhere to offer incentives all make moving out of state a better deal than remaining.
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