Georgia has a medical export problem. Three of every four graduates of Georgia medical schools this year went to do their residency training in...

Georgia has a medical export problem.

Three of every four graduates of Georgia medical schools this year went to do their residency training in other states. That’s important because the bulk of physicians end up practicing within 60 miles of where they did their training.

And Georgia is also mired in a doctor shortage that shows no sign of easing.

A “Primary Care Summit,’’ held Friday at Clayton State University in Morrow, outlined the residency and doctor shortage problems to an audience of medical school leaders, health care executives, representatives of doctor organizations, educators, and federal and state officials.

“We are positioned to become the biggest exporter of medical students,’’ said Denise Kornegay, program director of the Georgia Statewide AHEC Network, which sponsored the meeting. Area Health Education Centers (AHECs) address problems of health professional supply and distribution in rural and underserved areas of the state.

Primary care physicians are in particularly short supply in Georgia. This need for obstetricians, internists, pediatricians and family medicine doctors will become even more acute if the health care reform law is implemented, because it will add hundreds of thousands of patients to the state’s Medicaid rolls in 2014.

The nation as a whole has a primary care problem. The Health Resources and Services Administration estimates there will be a shortage of 65,000 primary care physicians in the U.S. in 2020.

Georgia’s five medical schools have increased enrollment since 2000, but most current med school graduates are choosing to pursue specialist training instead of becoming primary care doctors.

One major need, Kornegay said, is for Georgia to increase the number of residency positions, where doctors receive their clinical training. The state would need 315 more physician residency slots to match the Southeast average.

Those slots require significant investment from hospitals and health centers that provide them, Kornegay said. “The state will have to kick in money,’’ she added.

Georgia can make its residency programs more attractive by increasing pay and offering incentives such as school loan forgiveness programs, she said. The  slots that Georgia offers first-year residents pay less than surrounding Southeastern states, she noted.

Friday’s primary care meeting focused on formulating a plan to address the primary care shortage with legislators and other state leaders.

The alarming statistics include:

* Georgia has grown rapidly in population since 1990, but has just 200 doctors for every 100,000 people, versus the national average of 300.

*  In a sign of maldistribution, 52 percent of Georgia physicians are located in five “primary care service areas’’ that represent 38 percent of the state’s population, according to the Georgia Board for Physician Workforce.

*  34 percent of Georgia physicians were not accepting new Medicaid patients in 2008.

* Twenty-five of Georgia’s 159 counties lack a pediatrician, and 34 counties have no obstetrician.

The Georgia Obstetrical and Gynecological Society told GHN recently that several towns have lost obstetricians. Here’s a recent GHN article about an ob/gyn leaving the state.

In rural areas, low reimbursements from government insurance programs have made physicians’ practices less financially viable, and their workloads have become so great that many experience burnout, Jimmy Lewis of HomeTown Health, a rural hospital organization, told GHN recently.

On top of all the other problems, many of the state’s current physicians are getting ready to retire, Kornegay said.

“What we’re doing now is not working,’’ she said. “We can’t stand still or we’re moving backward.’’

 

 


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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