States Running Out Of Doctors

There are several ways to measure what many experts describe as a shortage of physicians in some parts of the United States. The first is the ratio of doctors per thousand people. America’s rank among developed nations is fairly low by that measurement. The US has 3.12 doctors per thousand people, or about 950,000 physicians in the entire country. Countries such as Israel, Belgium, Greece, and Italy have ratios more than 50% higher than America’s. This is probably due to universal healthcare in those counties. Based on this data, the US would need to add many more doctors quickly as national healthcare is phased in.

The more important numbers for Americans is the ratio of doctors available by regions, especially in those regions where the ratios are very low. 24/7 Wall St. looked at doctors per 1,000 people by state using analysis of American Medical Association data, information from the US Census, the Association of American Medical Colleges, state healthcare organizations the Henry J. Kaiser Family Foundation, the Organisation for Economic Co-operation and Development (OECD), and the Health Resources and Services Administration.

The most striking piece of information shows how much lower the doctor/population ratio is in some states. It is only 2.03  per thousand people in Oklahoma, and less than 2.2 per thousand in Idaho, Mississippi and Iowa. There is no distinct pattern among these. It could be argued that each is a rural state, but beyond that the four do not have much in common.  Mississippi is a relatively poor state with a relatively poorly educated population. That is not true of Idaho, Iowa and Oklahoma.

The other data which 24/7 Wall St. identified as important is the rate at which the doctor to population rate has grown over the last decade and a half. The national average for this growth from 1995 to 2009 was 15.56% based on AMA data. Several state growth rates were far below that. This is a factor in medical care now and may be more so in the future. The Association of American Medical Colleges recently reported that “Experts warn there won’t be enough doctors in the next 15 years to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 by then.” States that are well behind in the rate of increase of doctors to patients over the last 15 years will have trouble meeting their needs 15 years from now . It will be hard to play catch-up as the demand for physicians grows so quickly across the country

• Click Here For The Ten States Running Out Of Doctors

The doctor population will be stretched in several directions. Some of those directions are based on current problems. Malpractice lawsuits has cut the number of specialists in some regions. This is particularly true of certain kinds of surgeons and obstetricians. Tort reform has been modest.  Even if abusive lawsuits are curbed dramatically, the time it would take to fill the depleted ranks of these specialists in certain regions would take years. Doctor shortages are also acute in many regions which are poor or rural where practioners are not paid well.

Nearly every national problem from driver safety to consumer spending seems to be tied to Baby Boomers whether it is an exaggeration or not. The doctor problem can be added to that list. The aged need more care in general. They are more likely to have heart disease and cancer need transplants and make visits to emergency rooms.

This is 24/7 Wall St.’s States Running Out Of Doctors. It includes several pieces of data for each state. It is ranked by the states with the slowest growth rates among the 50 based on doctors to 1,000 people from 1995 to 2009.

Read on for the Ten States Running Out Of Doctors.

The Ten States Running Out Of Doctors

10. New York
> Change in Physician/Pop. Ratio (1995-2009): +12.15%
> Physician/Population Ratio: 4.43
> Total Physicians: 86,506
> Total Pop. (000): 19,541

Some hospitals in New York have already been forced to curtail services due to a shortage of doctors.  According to the Healthcare Association of New York State, 57% of hospitals in Central New York reported that there were times in 2009 when the doctor shortage left their emergency rooms without certain kinds of coverage.  The Association also reported that 28% of Central New York hospitals had to reduce or eliminate services entirely due because they lacked enough physicians.  The problem is expected to become worse as more doctors retire in coming years.  Currently, 27% of New York doctors are over the age of 60.

9. California
> Change in Physician/Pop. Ratio (1995-2009): +12.1%
> Physician/Population Ratio: 3.15
> Total Physicians: 116,489
> Total Pop. (000): 36,962

According to the California HealthCare Foundation, six out of nine regions in California are experiencing a shortage of primary care physicians.  Just under 30% of the state’s physicians are older than 60 years — the highest rate among all 50 states.  Unfortunately, while the state’s population has increased 20% in the last 15 years, graduation rates from the state’s eight medical schools have remained relatively unchanged.  To help combat the doctor shortage, the University of California, which runs 5 of the state’s medical programs, has announced plans to expand student enrollment and to open two new medical schools.

8. Maryland
> Change in Physician/Pop. Ratio (1995-2009): +12%
> Physician/Population Ratio: 4.76
> Total Physicians: 27,153
> Total Pop. (000): 5,699

Maryland residents “don’t have enough primary care providers and our medical schools aren’t producing enough,” Sen. Delores Kelley of Maryland recently announced at a state health care meeting.  Despite being home to the world-renown Johns Hopkins University, the state is graduating too few new physicians. According to the American Medical Association, Maryland, among other states, is considering legislation to expand the authority of nurses in the state as a way of shrinking the doctor/patient gap.

7. Delaware
> Change in Physician/Pop. Ratio (1995-2009): 11.95%
> Physician/Population Ratio: 2.81
> Total Physicians: 2,488
> Total Pop. (000): 885

The rate of increase for physicians in Delaware is just over 75% of the national average.  Although the state has not yet suffered greatly due to their shortage, an increase in newly insured patients because of health care reform may soon change that.  The state is already devising ways to deal with the issue.  One system set up in the state to aid areas which lack enough doctors is the use of eCare programs, where Delaware-based physicians electronically monitor patients in critical care and report anomalies to onsite nursing staffs.

6. Texas
> Change in Physician/Pop. Ratio (1995-2009): 11.63%
> Physician/Population Ratio: 2.40
> Total Physicians: 59,482
> Total Pop. (000): 24,782

As of 2009, 114 of the 254 counties in Texas have been designated by the Health Resources and Services Administration as primary-care shortage areas, with 27 counties not having any doctors at all.  According to the chief medical officer at JPS Health Network, quoted in the Star-Telegram, it is lack of funding that has left Texas with more medical school graduates than available residencies, thereby driving doctors out of the state.  This shortage of doctors is expected to worsen if action is not taken in the near future.  Texas’ doctor shortage is especially severe in rural areas.

5. Oklahoma
> Change in Physician/Pop. Ratio (1995-2009): 11.54%
> Physician/Population Ratio: 2.03
> Total Physicians: 7,476
> Total Pop. (000): 3,687

Oklahoma’s statewide rate of 2.03 physicians for every 1,000 residents is the lowest rate in the nation.  Worst still, 66 of the state’s 77 counties fall short of the national standard of one primary care doctor for every 3,500 residents.  Lawmakers have proposed one program called the Oklahoma Physician Recruitment and Retention Program, which would help fund doctors who make a four-year commitment to practice in communities being hit especially hard by the doctor shortage.

4. Mississippi
> Change in Physician/Pop. Ratio (1995-2009): 10.16%
> Physician/Population Ratio: 2.06
> Total Physicians: 6,078
> Total Pop. (000): 2,952

Mississippi has the third lowest ratio of physicians to residents in the country — 2.06 physicians for every 1,000 residents.  The state also has more than half a million people who may gain health insurance under the new health care laws.  According to experts, the state’s doctor shortage will likely become increasingly severe.  In an effort to lessen the impact of the shortage, the University of Mississippi Medical Center is working to increase medical school enrollment by increasing the size of entering classes from 135 students to 165. A lack of funding has slowed the effort.

3. Utah
> Change in Physician/Pop. Ratio (1995-2009): 10.05%
> Physician/Population Ratio: 2.41
> Total Physicians: 6,701
> Total Pop. (000): 2,785

Utah is one of the few states, along with California and Indiana, where medical schools have reduced enrollment due to state budget cuts.  This decision will hurt a state that already features one of the lowest increases in the rate of doctors over the last 15 years.  As a result, residents of Utah are beginning to rely more heavily upon nurses and physicians’ assistants for medical treatment.

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2. Georgia
> Change in Physician/Pop. Ratio (1995-2009): 9.38%
> Physician/Population Ratio: 2.45
> Total Physicians: 24,092
> Total Pop. (000): 9,829

Georgia’s physicians have not had a raise in their medicaid-based pay in more than a decade. The state’s new budget proposes a 1% cut in pay from the federal program for both doctors and nurses. With an already severe shortage of physicians – due largely to a stagnant graduation rate from in-state medical schools – the pay cut is likely to further erode the doctor/patient ratio.  Rural regions in the state, where some towns only have one doctor, are particularly at risk.

1. Arizona
> Change in Physician/Pop. Ratio (1995-2009): 4.56%
> Physician/Population Ratio: 2.52
> Total Physicians: 16,608
> Total Pop. (000): 6,596

Arizona has, by far, the lowest increase in physicians since 1995, when compared to the state’s population.  Furthermore, the state’s ratio of 252 physicians for ever 100,000 residents is significantly lower than the national average of 312.  To make matter worse, the state recently slashed funding used to train student doctors at hospitals.  This will, undoubtedly, drive some medical residents out of the state.  According to St. Luke’s Health Initiatives, a public foundation for policy research, the state needs 2,200 more primary care doctors through 2020 just to maintain its current ratio.

Douglas A. McIntyre and Charles B. Stockdale