A new report from the leading advocacy group for medical care in the state of New York indicates the number of doctors will continue to slide in several Western New York counties.
The new figures from the Healthcare Association of New York State follow a study from 2009 that showed a rise in the number of doctors entering retirement. It states the latest information from the region shows the dilemma of retiring "baby boomer" physicians is compounded by "difficulties in recruiting new talent" to replace them.
The HANYS study reveals that in 2009, 130 physicians retired or left Western New York, and another 287 are expected to do so by the end of 2011. Since 43 percent of physicians in Western New York are over the age of 55, it argues this trend will continue for the foreseeable future.
LOCAL ACTION TEAM
These statistics are nothing new to Jamestown's Strategic Planning and Partnerships Commission. In May 2009, the SPPC invited Dr. Lillian Ney to return to a leadership role as chair of the new health care action team.
"We've been trying to get our arms around the most significant issues, and spending the most time with physician recruitment," said Dr. Ney, who served as medical director of both JAMA and WCA before leading the action team. "We feel that is the most critical issue."
She said the group meets monthly, and has grown to include representatives from WCA Hospital, its board of directors, The Resource Center, and Jamestown Area Medical Associates. In addition, the co-chairs of the SPPC and leadership of two area foundations are invested in the group.
"It takes a community to hire a doctor," said JAMA Executive Director Kevin Saff, who is also a member of the action team. He said the group "brings the community together and that includes support from the foundations. Because it isn't just a problem for WCA and JAMA, it's a problem for the community."
Dr. Ney said even before baby boomers started to retire the local community has had to deal with a shortage of physicians. A large factor on active recruitment is the fact that the Western New York region has the lowest reimbursement rates in the nation for Medicare and Medicaid, she said.
"Even traditionally there has not been a filling of the ranks," she said, and she added while it takes a while to educate and train doctors, the upcoming professionals tend to stay in the area they first started their medical training.
The action team has broken ground in the effort to recruit new doctors, said Dr. Ney. Recently, she said the Chautauqua County Health Network has shared its list of medical students whose families or relatives reside locally. She added the organization has had success with an annual reception for these students.
Saff said part of the "grow your own" strategy means "tagging local students" who are going away to medical school and their residency programs. And Dr. Ney said WCA has embraced a commitment to give out stipends for medical students visiting from elsewhere. She said an agreement has been extended to Lake Erie College Of Osteopathic Medicine in Erie, Pa. and the University at Buffalo's School of Medicine.
WCA Hospital President Betsy Wright said the hospital has recently enlisted Dr. Bert Rappole to coordinate clinical rotations for students enrolled in their third and fourth year of medical school. And she said the hospital is active "on the front end of the educational experience" - as a job fair was recently held to showcase the medical profession to middle and high school students.
RECRUITMENT STRATEGIES
Dr. Ney said there are competitive markets even within Western New York, and some hospitals offer signing bonuses and have endowments at their disposal for student loan compensation. Dr. Ney said it is a sobering reality that new physicians could be up to $250,000 in debt, and looking toward larger markets and specialized practices as an alternative to residence at a community hospital.
"This area needs a common recruitment strategy," said Dr. Ney. "It would be wonderful to have a community-wide recruitment position or consultant," though she added it would be a challenge to balance the needs of various organizations, including specialized medicine in relation to the need for general practice. She said there are staff working on physician recruitment at WCA and JAMA, but the work continues to determine how to manage the needs of the entire community.
Saff explained the recent hiring of four physicians at JAMA cost $100,000 up front just for the recruiting firm that went out to collect resumes of eligible doctors. Costs like this require JAMA to be very efficient, he added.
He said it is hard to break through with a winning financial package since other markets can offer similar benefits for new doctors, and what will bring doctors is the allure of living and raising a family in the community. Dr. Saff said the action team has become a great asset, that "if we discover a potential doctor likes skiing or sailing," for instance, the team can call up someone locally to highlight those features.
"Chautauqua County is a great place to raise a family, that is what we have to offer," Saff said. "We can show a doctor a great practice opportunity, but if we can't show them a great community to raise a family, it's simply not going to work."
At WCA, Ms. Wright said the average age of its physician staff stands at 51.8, which is in line with the statewide figure of 52 years of age, as stated in the HANYS study.
"Basically, we try to work with members of our staff to plan when they might be retiring," she said.
She added it is crucial for the hospital to retain its doctors in the local area. In addition to financial incentives, she said the hospital is committed to "smoothing out the bottlenecks" during a physicians tenure, and ensuring that doctors and their patients continue to experience high satisfaction rates during their care. That requires WCA to maintain quality support staff and continue to improve the facilities.
The complete HANYS report is available at www.hanys.org/news.
