A move in Washington to cure doctor shortage

With health care reform the rage in Washington, Congresswoman Kathy Castor may have her best shot at helping to stem the doctor shortage facing Florida in the not-too-distant future.

The Tampa representative wants to make sure the Resident Physician Shortage Reduction Act is included in the reforms Congress debates.

It's important legislation because this fall Florida will have six medical schools open, but the state doesn't have enough residency slots in hospitals for graduating physicians to continue their training. And Florida badly needs young doctors.

More than 40 percent of the state's physicians are older than 55. As these doctors begin to retire, significant gaps in access will emerge if physician supply cannot keep up with demand. Moreover, for many Floridians their only access to a primary care doctor is through a resident physician.

Today, Florida ranks 44th of the 50 states in the ratio of resident physicians per 100,000 people but fourth in retaining physicians if they complete their residencies in-state. Those statistics suggest that if we increase the residency slots, more doctors will establish or join practices in Florida when they finish their training. The bipartisan legislation Castor and Sen. Bill Nelson advocate would provide funding for 15,000 additional residencies around the nation.

As Dr. Steve Klasko, USF vice president and dean of the medical school, points out, "No health care reform is going to work if we don't have doctors."

Significantly, the legislation also includes incentives - among them, loan forgiveness and scholarships - for medical students to seek family and internal medicine residencies rather than other specialties.

A survey last year of 1,200 fourth-year medical students found just 2 percent planned to work in primary care internal medicine.

Many doctors leaving medical school are strapped with six-figure debt so they opt for more lucrative specialties. And practicing physicians say there are reasons other than salaries: reams of paperwork, the inability to spend adequate time with patients, the special demands of the chronically ill, among others.

But hopefully, the incentives being written into the legislation will catch the attention of these frontline doctors of the future.

Expanding medical residencies won't come cheap. The estimated cost is $156 million over three years, but the alternative is more costly: Without access to doctors, Floridians with health problems will not receive the care they need, and health care costs will continue to skyrocket.

Florida medical schools produce high-quality graduates, but we need help from Congress to keep their healing hands here.