Why is there such a serious shortage of doctors in New Mexico ?<\/p>\n
A bit of good news:\u00a0 the basic cause is not anything inherently wrong with\u00a0 New Mexico.\u00a0 It\u2019s tied up in the complications of medical regulations and funding.<\/p>\n
A group of speakers from New Mexico Health Resources, Inc., (NMHR) recently described the background of this situation and what they are doing about it. NMHR is a nonprofit dedicated to recruiting and retaining physicians in New Mexico, especially underserved areas. The speakers were Jerry Richardson, executive director; Kevin McMullan, health professional recruiter; and Dr. Frank Hesse, a founder and former board member of NMHR who is also former chair of the now-moribund New Mexico Health Policy Commission.<\/p>\n
The undersupply of doctors nationwide, they said, traces to a federal commission called the Council on Graduate Medical Education.\u00a0 This commission was founded in the 1930\u2019s, when the nation had an oversupply of doctors. \u00a0A quota was established for the number of medical residents.\u00a0 Today, the training of medical residents is largely subsidized by Medicare.\u00a0 The quota sets the number of residents in each teaching hospital that Medicare will support.\u00a0 It also sets the allocation among specialties.<\/p>\n
It\u2019s possible for a teaching hospital to add more residents if another source of funding, such as state government, can be found.\u00a0 Though the outcome won\u2019t be known until the Governor signs the budget bill, possible funding for a few slots was a line item in the budget this year.<\/p>\n
Nationally, the shortage of physicians is expected to be more than 91,000 by 2020 \u2013 partly but not entirely due to the Affordable Care Act, which promises access to health care to millions more Americans. \u00a0In New Mexico, the shortage is estimated at 2,000 physicians, of which 400-600 are primary care physicians \u00a0(PCPs).<\/p>\n
Doctors have a significant financial incentive to become specialists rather than PCPs:\u00a0 specialists earn more than double what PCPs earn.\u00a0 Nationally, orthopedic surgeons are at the top, earning more than $400,000 annually, with cardiologists close behind; PCPs are at $175,000.\u00a0 Medical students graduate with a debt averaging $170,000, adding pressure to the incentive to choose a high-paying specialty.\u00a0 According to Hesse, social factors add to the pressure:\u00a0 there\u2019s more prestige attached to those high-paying specialties.<\/p>\n
Doctors get paid more in some states than others, also largely because of federal policy. Medicare sets physician reimbursement rates based on a cost of living formula, and New Mexico rates are low. \u00a0Insurance rates are often based on Medicare\u2019s rates. \u00a0This is another reason for doctors to locate somewhere else.<\/p>\n
Various financial incentive programs exist to help doctors who practice in underserved areas.\u00a0 NMHR tries to match the programs with doctors who express \u00a0interest.\u00a0 \u00a0But nobody thinks those programs will be enough, if New Mexico is competing for a limited number of doctors.<\/p>\n
Among the solutions recommended by NMHR:\u00a0 Congress should get rid of the cap on the subsidy for medical residents.<\/p>\n
I would call that a screaming emergency.\u00a0 It is outrageous that, with a nationally recognized and widely publicized need for more doctors, federal policy would create an artificial limit.\u00a0 \u00a0Opening the doors to the medical schools might be expensive in the short run, but it will save billions in the long run.\u00a0 The policy wonks at the Congressional Budget Office can figure out how much.<\/p>\n
This talk was just about doctors, with a focus on primary care.\u00a0 There was only brief mention of other aspects of the state\u2019s health care needs \u2013 mid-level practitioners, alternative care, distance medicine, dental care and the great need for some New Mexicans to take better care of themselves. \u00a0No matter what else we do, and even if every diabetic in the state suddenly becomes a health nut, there are some things for which we\u2019ll always need doctors.<\/p>\n
Triple Spaced Again, \u00a9 New Mexico News Services 2014<\/p>\n
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Why is there such a serious shortage of doctors in New Mexico ? A bit of good news:\u00a0 the basic cause is not anything inherently wrong with\u00a0 New Mexico.\u00a0 It\u2019s tied up in the complications of medical regulations and funding. … Continue reading