The Physician Shortage Crisis and the Small-Town Hospital

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DSH-thumb1Perhaps no section of the country is being hit harder by the physician-shortage crisis than small-town America. In fact, the U.S. Department of Health and Human Services has designated 5,900 regions of the country as Health Professional Shortage Areas (HPSA).

These areas affect one in five Americans, reports Sam Shawver for the Marietta Times. “HPSAs are determined based on a ratio of one physician per 3,500 people, and Health and Human Services estimates it would take approximately 7,550 additional primary-care doctors to eliminate the current nationwide shortage.”

As you may have expected, healthcare reform and the influx of newly insured patients entering the system next year will probably cause the need for physicians to skyrocket, making the impact this shortage is having on small-town America even more profound.

Take New Matamoras in Washington County, Ohio, and its neighboring townships of Grandview, Independence, Liberty, and Ludlow. Washington County is designated as an HPSA area, Shawver writes, and this is reflected in the added responsibilities placed on its local officials.

According to Shawver, “New Matamoras Emergency Squad Chief Fred Hupp said a physician is made available in New Matamoras on a certain day each week, but the community has no full-time doctor, which is a problem for area residents who need medical care.”

Hupp told him, “Most people have to drive all the way to Marietta for physician care, and some don’t have the transportation to get there.”

As a result, he and his men end up filling the void, fielding “calls from people who want to be transported to the hospital for a runny nose or other minor problem – to use us like a taxi service.”

Nearby Marietta’s Memorial Health System is desperately trying to fight this access problem, even going so far as to recruit a physician to deal with individuals who are in need of temporary care and immediate attention. The service, called Care Connection Services, allows “people who call the health system’s physician referral line but can’t be placed immediately with a doctor…[to] be referred to Dr. Joy Chesnut at Care Connection Services,” who will handle their needs.

Chestnut, who is 41, said, “Marietta is the first system I’ve seen that has been trying to actively address the primary-care issue. And because the need for primary-care doctors is so large some doctors can be selective about the patients they receive. It’s a supply and demand issue that can create inequities for patients.”

Meanwhile, Memorial Health System is striving to recruit physicians through websites and headhunters.

They’ve had some success in the hiring of Chestnut and other skilled physicians who were attracted to the low cost of living and the moderate size of the area. The system also keeps its eye on the future, remaining in contact with students who lived in their area and have gone on to medical school. One Memorial official said “about half of the students from this area who are headed into the medical field are interested in returning to practice in their hometown.”

Regardless, the shortage is being felt in Marietta and its surrounding communities, as well as many other places around the country. Are you and your organization in one of these HPSA communities? How are you as a healthcare executive confronting the physician-shortage crisis?

-by Pete Fernbaugh

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