Published: July 10, 2008 11:57 am      

Physician shortage will grow in Western Md.

ROCKY GAP - One answer to the current "acute physician shortage" facing Western Maryland comes from tomatoes: They're better if they're home-grown.

A new state study recently found that after medical students complete their residency training, only 52 percent remain in Maryland to practice medicine. But even more disturbing, that number is projected to drop to 25 percent by 2020 - because most medical students who train here come from other states. And more and more, the emphasis is on returning to a student's home locale to practice. That's what was said at a forum of health care professionals Tuesday evening at Rocky Gap Lodge & Golf Resort.

"It's very worrisome that only about 25 percent of our physicians are saying they want to stay here," Dr. Robert Barish said. "In part, the number one factor among residents right now is they want to be close to home."

The chair of the Maryland Physician Workforce Study Steering Committee and vice dean for clinical affairs at the Maryland School of Medicine, Barish framed the current issue facing the state's physician work force for a packed crowd.

Western Maryland has 16 percent fewer physicians per population than elsewhere, and of the 34 specialty areas (pediatrics, geriatrics, internal medicine and so forth) the study examined, 67 percent have shortages right now. By 2015, the shortages are expected to grow to 73 percent, Parish said.

"The rural areas are getting hit hardest by these physician shortages," especially the poor and the elderly, he said.

Along with the shortage in doctors is a change in attitude being seen throughout the country, as more and more medical residents are focusing more on family than their jobs.

"Residents are saying family, family, family," Parish said.

It's part of a national trend, but only one of many that are causing health care experts concern. Due to current physician shortages that are expected to grow dramatically unless something changes, people are wondering how an aging physician population can keep up with an ever growing American population.

And even if the Association of American Medical Colleges and the American Medical Association meet their target goal of having approximately 30 percent, or about 5,000 more medical students per year, Barish said the first year that Western Maryland would benefit from that increase is 2022.

That fact alone underscores the situation the entire state, and the nation, finds itself in. Currently, there is an allotted number of slots that can be filled by medical residents each year. The Liaison Committee on Medical Education, along with other agencies that fund state or private academic institutions, determine how many slots a program can have. With the increase in students slated to begin in 2015, after a lead time of four years in college, and a minimum three years of residency training, Barish said the first year doctors will be produced from the effort is 2022.

And that doesn't even take into account medical specialists in fields such as psychiatry, obstetrics, pediatrics or internal medicine. Those doctors must train even longer than three years.

Barish told a packed crowd of health care professionals at Tuesday's that this problem and the resultant shortage of doctors in Western Maryland is hurting patients.

The situation doesn't look good, and it's not going to get better anytime soon, he said. Which is why the Maryland State Medical Society (MedChi) held the forum - so doctors, administrators and legislators can work together to effect a change.

Looking at the sole issue of the number of doctors in Maryland, Barish said the study took the nearly 25,000 licensed doctors in Maryland, and adjusted them for full-time equivalency. This meant deducting for doctors who are employed federally (with the exception of Veterans Affairs physicians) and for clinical doctors who also teach and research at the state's two medical schools.

This leaves only 10,227 doctors who practice full-time, Barish said. "No one had done this before," he added.

Considering that those doctors can't keep up with the number of patients now, Barish wondered who will treat people when the elderly population doubles by 2030, from 35 million to 71 million.

And even by 2020, also because of the number of rapidly expanding elderly patients, there's going to be 53 percent more doctor visits than today. "That's only 12 years away. Who's going to see all these patients?" Barish asked. "Right now there's trouble seeing all the patients. There's not enough doctors."

Another problem comes from the doctors, who are themselves growing older. Barish said almost 10 percent of Maryland physicians are over age 55. "We have an aging physician work force, we're not producing more physicians and there's gonna' be more and more patients coming to see the physician. That's almost the perfect storm," Barish said.

One way to help Maryland in general, and Western Maryland in particular, Barish said, is to retain more medical students, by helping them "find Maryland an attractive place to practice."

One practicing physician spoke up during the comment session to suggest the way to do that is to allow more Maryland students to train as doctors here. His belief that more out-of-state students are being trained here was repeated as a common problem by numerous other medical experts at the forum.

Contact Daleen Berry at dberry@times-news.com.