1 / 25

Where have all the physicians gone?

Where have all the physicians gone?. Kim Streit, VP/Healthcare Research and Information Florida Hospital Association. Florida’s Healthcare Environment. 1 st in % of population covered by Medicare 2 nd highest in % of uninsured 3 rd in # of paid medical malpractice claims

sean-morrow
Download Presentation

Where have all the physicians gone?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Where have all the physicians gone? Kim Streit, VP/Healthcare Research and Information Florida Hospital Association

  2. Florida’s Healthcare Environment • 1st in % of population covered by Medicare • 2nd highest in % of uninsured • 3rd in # of paid medical malpractice claims • High penetration of managed care • 17th in # of medical school graduates • 26th in patient care physicians per 100,000 population

  3. As the demand for health care services is growing….. 11.0 10.7 10.7 10.5 10.3 10.1 9.7 9.2 8.7 8.1 *ED visits are estimated and outpatient surgery data are for twelve months ending 6/30/06 Sources: AHCA Discharge Data, 1997-2006; AHCA Financial Filings, FY1997-2006

  4. …while the supply of physicians is shrinking. Physicians per 100,000 Population Source: Physician Characteristics and Distribution in the U.S., American Medical Association, 1997-2007

  5. Number of Physicians in Florida1996 - 2005 Source: Physician Characteristics and Distribution in the U.S., American Medical Association, 1997-2007

  6. 44 Percent of Florida’s Physicians are 55 years or older 2005 Source: Physician Characteristics and Distribution in the U.S., American Medical Association, 2007

  7. Little Growth in Medical School Enrollment Source: Association of American Medical Colleges, Web site, 2007

  8. Florida Ranks 43rd in Residency PositionsRatio of MDs and DOs in Training State Residency Positions Ratio Shortage (1) NY 15,903 82.7 0 (2) MA 4,841 75.4 0 (4) PA 7,153 57.7 0 (6) MI 5,166 51.1 0 …. (41) KS 502 18.4 -182 (42) ND 113 17.8 -46 (43) FL 2,963 17.0 1,386 Source: AAMC GME Track 2004, AOA, US Census Bureau, State Population Estimates, 2005

  9. Demand for Physicians will Exceed Supply of Physician by 2020 Subtitle Source: HRSA, “Physician Supply and Demand: Projections to 2020

  10. Projections of Supply and Demand by Physician Specialties in 2020 Surplus/ Supply Demand Shortage Primary Care General Family Practice 134,700 135,900 (1,200) General Internal Medicine 143,900 143,500 400 Pediatrics 66,100 57,900 8,200 Medical Specialty Cardiology 22,900 29,600 (6,700) Surgical Specialties General Surgery 30,800 52,200 (21,400) Obstetrics/Gynecology 51,600 47,200 4,400 Ophthalmology 19,100 25,200 (6,100) Orthopedic Surgery 25,500 31,600 (6,100) Otolaryngology 10,300 12,400 (2,100) Urology 9,600 14,400 (4,800) Other Specialties Emergency Medicine 36,300 31,800 4,500 Pathology 18,200 22,600 (4,400) Psychiatry 43,100 47,400 (4,300) Radiology 36,500 41,100 (4,600) Source: HRSA, “Physician Supply and Demand: Projections to 2020

  11. “A survey of Florida physicians, designed to assess the effect of the personal liability insurance market on access to care found that 54% of the physicians had indicated that the delivery of services have been decreased or eliminated..” JAMA “Availability of Physician Services in Florida, Revisited, 10/10/05”

  12. “More than two-thirds of hospital CEOs identified physician shortages as a serious problem that must be addressed soon” Council on Physician and Nurse Supply, AMN Healthcare, May 2007

  13. SB 770 “Physician Workforce Assessment and Development • “..recognizes that physician workforce planning is an essential component of ensuring that there is an adequate and appropriate supply of well-trained physicians to meet this state’s future health care service needs as the general population and elder population of the state increase. The Legislature finds that items to consider relative to assessing the physician workforce may include: • Physician practice status • Specialty mix • Geographic distribution • Demographic information • Must ensure the availability and capacity of quality graduate medical education • Must use new or existing state and federal programs or incentives to practice in needed specialties and underserved areas

  14. Coordination and Strategic Planning for Physician Workforce Needs • Department of Health will serve as a coordinating and planning body to assess the state's future physician needs.  • Develop a model and quantify the adequacy of Florida’s current and future physician workforce. • Develop strategies for addressing the current and future workforce needs, including programs to stimulate interest in the medical profession and expansion of GME positions in Florida. • Monitor, evaluate and report on the supply and distribution of physicians, including maintaining a database that serves as the source of information on Florida's physician workforce

  15. Expanded Florida Physician Database Additional information collected through licensure renewal process:  1.  Frequency and geographic location of their practice 2.  Practice setting 3.  Percentage of time spent in direct patient care 4.  Anticipated change to license or practice status 5.  Areas of specialty or certification 6.  Availability and trends relating to critically needed services such as as OB care, mammography, ED call coverage • Will not renew license if fail to complete the survey with the renewal application

  16. FHA Survey on Physician Supply and Shortages, August 2007 • Projected need: 15,279 additional physicians in next 3 to 5 years • Specialties in greatest need: • Internists • General practitioners • Pediatricians • OB/GYN • Orthopedic surgery • Cardiology • General surgery

  17. 97% of hospitals reported physicians relinquishing privileges in past 2 years • Leaving state • No longer need hospital setting • Retirement • ED call coverage requirement

  18. One out of Three Hospitals Reduced or Eliminated Services Due to a Physician Shortage in past 2 years • Eliminated Services • Neurosurgery • Hand surgery • OB • Opthalmology • Reduced • ENT • Urology • Orthopedics • Plastic • Neurosurgery

  19. Causes of the Shortage(Hospital Perspective) • Supply of available physicians – 95% • Low reimbursement rates – 82.5% • Medical liability climate – 76% • Working conditions – 73% • Retirement – 54%

  20. Hospital Employment of Physicians • 93.5% are anticipating employing more physicians in next 5 years • Specialties: • Internal Medicine • Family Practice • General Surgery • Neurology • Gastroenterology • Orthopedics • OB/GYN

  21. Hospitals Actively Recruiting Physicians • 97% are actively recruiting physicians • Recruited 1,418 physicians in last two years • Currently recruiting 984 physicians • Specialties being recruited • Family practice • Internal medicine • Orthopedic surgery • OB/GYN • Hospitalists • General surgery • Cardiology • 9 months to recruit (range is 5 to 24 months) • Takes between 6 and 12 months to take on patients

  22. Hospital Challenges in Recruiting Physicians to Florida • Medical liability climate – 83.1% • Supply of qualified candidates – 78.5% • Low reimbursement rates – 56.9% • ED on-call requirements – 49.2% • Cost of living/affordable housing – 41.5%

  23. In Summary • Ensuring adequate supply of physicians will be major challenge for Florida • Major systemic changes must occur to reverse trend • Must adopt approaches to use physicians more efficiently • Funding critical to increasing physician supply

  24. Florida Hospital Association www.fha.org 407-841-6230 850-222-9800

More Related