MOUNT VERNON — Rising insurance premiums, higher expectations on the part of consumers and changing lifestyles are making the life of a physician recruiter more difficult. Add in an anticipated shortage of physicians, and it can become a real headache.
Supply and demand play a role in medical economics, as in other financial spheres. The problem on the supply side, according to Bhagwan Satiani, M.D., MBA, begins with the number of physicians entering the system.
“The work force is fixed, the population has grown,” he said.
Part of the solution to the physician shortage, according to Satiani, a professor of surgery at Ohio State University, is an increase in the number of medical school graduates. Between 2007 and 2010, 10 new medical schools have opened or will open by next year.
“The people in the pipeline are slowly increasing,” he said.
On the demand side, it is a question of numbers, said Bruce White, chief executive officer of Knox Community Hospital.
“The baby boomer age group is moving into the period of their life where they will consume more health care services,” he said. “Life expectancy is longer, so the baby boomers will be around longer.”
White said the elderly consume health care at a rate of 2.7 times more than the younger population.
“In addition,” he continued, “there are higher expectations of what health care should be like.”
For example, he said, at one point an individual with knee or hip pain would have settled for getting around in a wheelchair. Now, he said, they are opting for a knee or hip replacement.
“They’re more demanding as consumers,” said White. “All of this is leading to a higher demand for physicians. Everything indicates we are nowhere near keeping up with what the demand will be.”
Satiani, along with co-authors Thomas E. Williams, M.D., Ph.D., and Chris Ellison, M.D., discusses the shortage of surgeons in a book titled “The Coming Shortage of Surgeons: Why They Are Disappearing And What We Can Do About It.” Published by Praeger Publishers, the book is due out in October.
“In our area here, we are fortunate we have not had a shortage of general surgeons,” said White. “We have pretty reasonable coverage for our area.”
White said that as part of medical staff planning, hospital administrators look at the demographics of the area in terms of number of general surgeons, for example. Patient information is also researched.
“For example,” he said, “are patients in our area leaving the community because maybe they are not able to access a general surgeon? We also talk to our medical staff, because the primary care physician knows whether they can get a patient in to see a general surgeon.”
Taking all of that into account, White said, it has been determined there is a need for three to four general surgeons in this area.
“So the fact that we have three puts us in pretty good position,” he said.
White said that although Knox County is not experiencing a shortage of surgeons, he is, in general, seeing a trend toward a shortage of primary care physicians.
“It’s generally known that cardiologists, urologists, orthopedic, psychiatrists, dermatologists, nephrologists — it’s tough to find subspecialties. But everybody has taken for granted the primary care physician will be there. So we’re actually seeing the shortage in the primary care arena,” he said. “There are declining numbers going into medicine, subspecialties tend to reimburse better, younger physicians don’t want to be on call all of the time, don’t want to have long hours in the office, and then have to go to the hospital and make rounds. That is a demand that nowadays young people are not willing to make.”
Satiani said another solution that would help keep current physicians from early retirement is the idea of job sharing or working part time. White agrees those are options, and cites the case of Dr. James Risko.
“Dr. Risko retired from his surgical practice, but was not ready to retire altogether, so he went into occupational health [at the hospital],” said White.
Specifically referring to surgery, he said, “Part time is an option if you do enough volume of surgery to keep your skills up. As long as you are doing enough volume, then I think that can make a lot of sense, if that fits their lifestyle choice.”
The part-time option does have a downside.
“In the rural community, if I have a need for a full-time physician of whatever specialty, part time can be a negative that might preclude a full-timer from coming here,” said White. “He or she may think there may not be enough volume to support my practice.”