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Wednesday, March 05, 2008

Surgeon and doctor shortages worst in rural areas

The nation is facing a shortage of doctors, especially surgeons, due to limits on medical-school enrollment of medical schools and the aging of Baby Boomers, reports Robert Davis of USA Today. The shortage is of greatest concern in rural America, "where only 9,334 of 211,908 physicians are general surgeons, according to American Medical Association data," Davis writes. "The Census Bureau defines 'rural' as open country or small towns with fewer than 2,500 residents." (USA Today photo by H. Darr Beiser shows David Lingle, one of two surgeons at Shore Memorial Hospital in Nassawadox, Va., which had seven a decade ago.)

The shortage began when U.S. medical schools capped enrollment in the 1980s and 1990s to avoid a surplus of doctors. Now the schools are boosting enrollment to catch up, but that will take time and other factors exacerbate the shortage in rural areas. Most medical-school graduates leave school more than $150,000 in debt, and want to pay it off sooner rather than later. It's harder to do that by going into general surgery, and even harde as a rural general surgeon, Davis reports:

"After an industry-wide review of allegations that surgeons were charging too much, Medicare lowered the amounts that the U.S. government pays doctors during the 1990s. For some common procedures, general surgeons now get about half the money they received 20 years ago," according to Josef Fischer, chairman of surgery at Boston's Beth Israel Deaconess Medical Center.

To solve the shortage, some suggest that "medical schools need to hunt for a slightly different type of student — those who want to practice medicine in rural areas — and focus less on attributes such as an applicant's previous clinical research," Davis writes. In addition, they reimbursement policies need to be changed to compensate doctors for treating rural patients "where they live." (Read more)

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