Doctor shortage remains acute in rural areas

Georgia’s physician shortage continues to limit patients’ access to care, especially in rural areas, a recently released report indicates.

But the report by the Georgia Board for Physician Workforce also highlights some promising trends on doctors practicing in Georgia.


The state ranked 39th in the ratio of doctors per 100,000 population in 2010, the latest year for which data are available. That’s a slight improvement from Georgia’s 40th-place ranking in 2008.

The report, for the first time, also tracked the distribution and number of physician assistants (PAs) in Georgia. PAs are not physicians but are qualified to perform many of the duties that doctors routinely handle.

The doctor shortage is most critical in primary care/core specialties,  which the Georgia board defines as family medicine, internal medicine, pediatrics, OB/GYN and general surgery.

And the primary care gaps are more critical in rural counties and some inner-city areas, said Cherri Tucker, executive director of the Board for Physician Workforce, which has been producing such reports since 1986.

“We’re not getting the physicians in fast enough to meet population demands,” Tucker said.

The overall population of Georgia increased by 18.3 percent from 2000 to 2010. The state’s physician workforce actually outpaced that, growing by 26 percent. But a breakdown of that workforce growth paints a less rosy picture.

The increase for primary care doctors was 14.5 percent, compared with 36.7 percent for specialist physicians. The numbers for family medicine, internal medicine and pediatrics all improved, while ob/gyn and general surgery actually fell.

Meanwhile, the overall physician population is aging. More than half are 50 or older, the report found.

“It is a concern,’’ Tucker said. Nationally, many doctors are retiring early, at age 55, she said. “If physicians in Georgia opt to retire earlier, we will have a much worse shortage of physicians than we expect.”

2010 was the first year since the board began tracking physicians that each of Georgia’s 159 counties had at least one doctor who practiced primarily in that county.

But many counties lacked a primary care practitioner in a given field: Six counties had no family medicine physician; 31 had no internal medicine physician; and 63 had no pediatrician.

Additionally, 79 counties had no OB/GYN, and 66 counties had no general surgeon, the report said.

“This report further indicates the great demand for primary care in our rural communities,” Matt Caseman, executive director of the Georgia Rural Health Association, said Thursday. “We must be aggressive about recruiting and retaining our physicians.”

Studies show a rural physician can generate up to 23 jobs in the local economy, Caseman added.

The physician workforce in Georgia is growing more racially diverse. In 2010, 70.6 percent of doctors were white, down from 86.5 percent in 1992. About 10 percent of Georgia doctors speak Spanish, the report found.

There was an increase in the percentage of physicians who accept new Medicaid and new Medicare patients, in comparison to 2008.

The data for physician assistants, Tucker said, showed there isn’t a sufficient supply in the state,  and that they are not well distributed geographically.

PAs, along with nurse practitioners (who also can handle many of the duties frequently left up to doctors), are considered part of the solution to primary care shortages in rural areas, especially with the coverage expansions from the Affordable Care Act.

Yet the state was 35th in the number of PAs per 100,000 population, and a large majority, 78.7 percent, were practicing in metropolitan areas.

The report found 49 counties did not have a physician assistant who practiced primarily in that county. And just 3 in 10 Georgia PAs worked in primary care.

Tucker said to solve the physician shortage, the state needs more initiatives to recruit doctors and get them to remain in Georgia. Such programs include school loan repayments; an increased number of medical residency programs; and making the state a more attractive place for doctors to practice.

Here’s a link to the physician workforce report.