Thursday, July 24, 2014

News
Wisconsin facing pediatrician shortage
by Diane Moca


MILWAUKEE -- Extensive studies by the Wisconsin Hospital Association, the Association of American Medical Colleges, and the Wisconsin Office of Rural Health are projecting serious doctor shortages over the next 20 years, particularly in primary care physicians in rural and poor urban areas.

But when it comes to pediatricians, Wisconsinites are already facing a shortage now.

The Medical College of Wisconsin says fewer students are entering the field of children's medicine compared to other specialties.

"The shortage has been developing over time -- not a sudden, new problem, but it is a thing that has been getting worse," described Dr. Marc Gorelick, professor of pediatrics at the Medical College of Wisconsin.

Dr. Gorelick says there is one pediatrician for every 1400 patients nationwide and one pediatrician for every 2100 kids in Wisconsin.

"The average age of the physicians is going up as people are nearing retirement and not being replaced at the same rate that they are departing," added Dr. Gorelick.

For parents, that means a tougher time finding a pediatrician accepting new patients or a longer wait for the next available appointment.

"It's hard to get in with a doctor to see them on short notice," explained Jackie Verity.

Verity says taking her 6-month-old daughter Isadora to a pediatrician versus another type of doctor "does matter to me. I like the fact that he specializes in infants and children," she said. "He's focused on development and growth, and I feel real great with her being a patient of his."

The college professor says one of the main reasons for the shortage is money.

"With medical school debt going up, there's pressure to go into higher paid specialties," he noted.

The American Medical Association website says in 2011, medical students graduated with an average educational debt of $184,000 -- an amount that has more than tripled in the past three decades and will cost grads about $2,000 in loan payments every month.

The association says a surgeon, making about $400,000 per year, can make those monthly payments much easier than a primary care doctor like a pediatrician, who would make about $165,000 annually.

Dr. Gorelick says insurance companies pay more per hour to doctors who perform procedures than those who examine, diagnose and consult with patients.

"It's really sad that that comes down to it, but with the economy these days I can completely understand," said Verity

Dr. Gorelick says another factor is the 24/7 demands of pediatrics.

The children's hospital administrator says in recent years, medical students are increasingly drawn toward specialties like dermatology, radiology and other areas with predictable hours -- especially women, who dominate the field of pediatrics.

"Many of them are looking for part-time work. Many of them are looking for other accommodations if they're interested in having a family," he noted.

Dr. Gorelick says government cuts to funding for pediatric training, and threats to eliminate such programs, are adding to the move by graduates away from becoming a children's doctor

He says that opens up opportunities for students from foreign medical schools to pay for those training positions.

"If there are more residency spots available than there are American medical graduates going into them, then they get filled with others," explained Dr. Gorelick.

He says provisions in the Affordable Care Act are designed to address the growing shortage of pediatricians and other primary care physicians through an increase in government insurance reimbursements for medical services, which tend to be lower than that of private insurance.

"Part of the Affordable Care Act is that, (for) pediatrics and pediatric specialties... Medicaid has to pay at least at the level of Medicare," outlined the CEO of Children's Specialty Group.

He says recent health reforms have renewed the emphasis on patients seeking care first from a primary care doctor, which should create more demand for pediatricians because they provide primary care for children.

The college is also developing ways to cure Wisconsin's shortage of primary care physicians, especially where it has hit the hardest -- areas where many children are covered by Medicaid.

"In particular poor urban areas and rural areas tend to have even bigger shortages," Dr. Gorelick noted. "We're embarking on our community medical education program."

The program will expand the number of slots for medical students at new branch campuses in Green Bay and Central Wisconsin slated to open in 2015, to address the lack and maldistribution of pediatricians and other primary care physicians.

"We're going to recruit students who are interested in being in those communities," he enthused.

The college is also hoping to shorten the training period so doctors will graduate with less debt, and to educate more providers who assist physicians, such as nurse practitioners.

"A lot of primary care can be provided very effectively and efficiently by nurse practitioners for example," said Dr. Gorelick.

But many parents specifically want a doctor who specializes in babies and kids.

Verity says she'd even be willing to pay more to take her daughter to one.

"There's nothing more precious to us than her," she insisted. "So we would do whatever we had to do to make sure that she was getting the best care possible."

If you have an issue you'd like us to investigate, send an email to dmoca@cbs58.com.