Why there are not enough doctors and what is being done about it
If you’ve recently called a doctor’s office to make an appointment as a new patient, you’ve probably been told that the wait time to get in could be weeks or even months. Across the country, patients are struggling to find primary care physicians.
Paging DOCTORS ON THE CENTRAL COAST
“Oh, that’s so annoying, man.”
Like many on the Central Coast, Jerry Ross is struggling to find a new primary care doctor.
“Any time you can’t get a doctor’s help, it’s a crisis, especially when you need it,” he said.
Ross’ longtime doctor switched to concierge medicine, meaning he would have to pay in advance for medical services.
The average cost of concierge medicine is usually between $1,500 and $3,000 per year.
Ross, who is retired on a fixed income, cannot afford it.
“No way,” he said. “I mean, if I didn’t want to eat or, you know, drive. Yes.”
After several calls to different clinics, he finally got an appointment.
“She [the receptionist] says “well i can accommodate you but she is there [the doctor] without seeing anyone. Her first appointment is scheduled for January 18, 2024.” I say, “A year?”
Ross is not alone. Across the country and on the Central Coast, the doctor shortage is worsening.
In California, only about half, or 49.09%, of the state’s primary care needs were met in 2022, according to the Kaiser Family Foundation.
I asked Dr. Scott Robertson, president and CEO of Central Pacific Health Centers, if we have enough doctors to meet the needs of our population.
“Absolutely not,” he said. “I’ve been here 20 years, doing primary care and being an administrator at Dignity Health, and we haven’t had enough the whole time I’ve been here.”
On the Central Coast, Dr. Robertson says it often takes weeks to months to get an initial appointment with a primary care physician. If there was no shortage, it would be one to two weeks.
WHY WE DO NOT HAVE DOCTORS
What is the reason for the shortage of doctors? Dr. Robertson says the answer is complicated. Locally, the high cost of living on the Central Coast is one of the many reasons we see fewer doctors.
“As you know, the cost of living here on the Central Coast isn’t really that much lower than some of these big metropolitan areas in California, and so doctors are really faced with whether or not you want to take a pay cut. And that’s extremely important for primary care. nursing, which is already one of the lowest paying specialties, and many of these doctors are now coming out of medical school with 2, 3, even $400,000 in debt. financial decisions are extremely important to them and their future.”
In 2019, state data showed that nearly a third of residents in San Luis Obispo County (33%) and Santa Barbara County (31%) live in areas with primary care shortages, meaning that for every 2,000 or more citizens there are only one full-time doctor.
The latest government data for 2020 includes nurse practitioners and physician assistants as well as physicians, but the Central Coast continues to fall short.
The Central Coast is considered a rural area, which also contributes to the shortage and the challenge of attracting more doctors to our area, which means doctors are compensated less compared to doctors in larger metropolitan areas like Los Angeles or San Francisco. This means less pay for doctors.
Dr. Rene Bravo is a trustee of the California Medical Association. They have been in constant communication with legislators to address the ongoing deficit.
“I think the biggest problem is that because of the lack of primary care, it stresses the safety net, which means the emergency system,” he said. “Emergency rooms are increasingly seeing patients who probably don’t have emergencies, but they don’t have doctors either.”
Pandemic physician burnout from the COVID-19 pandemic has exacerbated the shortage, forcing some doctors to cut hours or leave their jobs, Bravo says.
The American Medical Association is also expecting a wave of retirements — a significant number of physicians are approaching retirement age. That’s a third of the doctors in California.
“I’m getting close to Medicare age myself and I don’t have a primary care doctor. They left and I’m in the same boat as many, many people here and I’m a doctor who’s been here for almost 40 years.” said Dr. Bravo. .
WHAT IS BEING DONE TO MEET PATIENT NEEDS
I asked Central Coast Health Centers what is being done to meet the demand.
Lompoc Health has created alternatives for those in need of a primary care physician by staffing the urgent care center with physicians, physician assistants and nurse practitioners. They offer the ability to make an appointment and meet on the same day or the next day.
Tenet Health works with staffing firms to recruit physicians and conducts weekly interviews with physicians in a variety of specialties.
Dignity Health has started an internship program at Marian Regional Medical Center in Santa Maria. “The program has been very successful,” said Dr. Robertson. “You’re never going to have 100% physician retention, but we’ve had about 60% physician retention since the program started producing graduates about 4-5 years ago.”
Cottage Health is expanding its graduate medical education program and recently developed a pediatric residency to recruit and retain physicians. More than 100 doctors who trained at Santa Barbara Cottage Hospital have stayed or returned to the area to practice.
At the state level, the California Medical Association advocates for new medical schools, expanded educational opportunities and expanded loan repayment programs. CMA is also supporting a bill in the state legislature that aims to bring more physicians to underserved communities through fellowships.
But these decisions will take time.
For patients like Jerry Ross, all he can do is wait and hope.
“[I’m] hope I don’t get sick,” Ross said.