States struggle with physician shortages, health care workforce issues

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Jun 28 2010

Worcester (Mass.) Telegram & Gazette, reports on a national shortage of pediatric subspecialists. "While Massachusetts has more pediatric sub-specialists per capita than many other states, the doctors are in short supply, even at big institutions like UMass. … Pediatric sub-specialists go through several years of training: four years of medical school, three years of training in pediatrics, then another three years of training in a specialty," yet their salaries are not much higher than regular pediatricians. "As a result, pediatric sub-specialties are not attractive to many doctors-in-training worried about paying for medical school. … Because of the shortage, children in many parts of the country, including Massachusetts, wait weeks and sometimes months to see specialists." Others must travel long distances to find the appropriate specialist. Doctor groups have been lobbying Congress to increase reimbursement rates for pediatric subspecialists, and the new health law "includes a provision that offers loan relief of up to $35,000 per year for up to three years for students who choose to become pediatric sub-specialists. The measure calls for $30 million a year in federal spending from 2010 to 2014, but the funds have yet to be appropriated" (Dayal, 6/27).

Policymakers in New Jersey are "acting with added urgency on the worsening shortage of physicians, a statewide problem that is hitting southern counties particularly hard," NJ Spotlight reports. "Experts trace the shortage to a number of factors at various levels of the system. For one thing, there's an insufficient number of available slots in New Jersey's medical schools. For another, med students that complete their training face burdensome loan repayment. The New Jersey Council of Teaching Hospitals consortium also warns that New Jersey is losing doctors to other states because of what it terms a 'hostile practice environment' characterized by the high cost of living, high taxes and the high price of medical malpractice insurance. … A January 2010 report from the Council of Teaching Hospital notes that except for Camden, every county south of Burlington and Ocean already falls below the national average of 88 primary care physicians per 100,000 residents" (Hernandez, 6/28).

Meanwhile, California's "Board of Registered Nursing has discovered that some 3,500 of its nurses have been punished for misconduct by other states — hundreds even had their licenses revoked — while maintaining clean licenses in California," the Los Angeles Times and ProPublica report. "As many as 2,000 of these nurses now will face discipline in California, officials estimate. That's more registered nurses than the state has sanctioned in the last four years combined. The board's discovery was prompted by a Times/ProPublica investigation last year that found hundreds of instances in which California nurses had been sanctioned elsewhere for sexual abuse, neglect, rampant drug use and criminality but could work freely in California" (Weber and Ornstein, 6/28).

Meanwhile, The (Minneapolis-St.Paul, Minn.) Star Tribune reports on a nursing strike in the Twin Cities, where some nurses are resisting the action. Thousands of nurses from the Minnesota Nurses Association "have turned out by the thousands for picketing, picnics and other shows of solidarity. … But as they draw within days of what could be a historic walkout, some dissenters are saying it's time to speak out, voicing concerns about their union's aggressive tactics, what they consider reckless accusations of unsafe staffing, and the risks of walking away from good jobs in a bad economy. Even if their numbers are small, they could prove pivotal if they refuse to support a strike called for July 6" (Yee and Lerner, 6/28).

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.