D.C. has fewer than 3,000 active doctors, report says

Correction: An earlier version of this article misstated the percentage of the District’s population living east of the Anacostia River. According to the 2010 Census, about 23 percent of D.C. residents, not 50 percent, live in wards 7 and 8. This version has been corrected.

September 28, 2011

A new report on the number of physicians practicing in the District appears to confirm what many patients already experience: It’s not easy to find a doctor in Washington.

The report by the D.C. Board of Medicine, to be released Wednesday, shows that 8,940 doctors are licensed to work in the nation’s capital, but only about 4,000 practice in the District. And of those, only 2,821 spend more than 20 hours a week seeing patients.

The numbers drop even further among actively practicing primary-care doctors: 382 in internal medicine, 307 in pediatrics, 119 in obstetrics and gynecology, and 110 in family practice.

The report provides what board officials say is the first detailed snapshot of the physician workforce in the District. It was drawn from a survey during license renewal last fall and early this year. It does not draw conclusions about shortages, but the numbers suggest more doctors are needed.

“People will complain they do not have access to physicians, and, holy cow, 9,000 have a license. But what ends up happening, only a fraction actually practice in the District,” said Janis Orlowski, board chair. “I think it’s not a lot.”

The report found that actively practicing doctors are clustered in Wards 1, 2, 3 and 5, near hospitals. Health-care experts said any shortages that might be perceived in the District depend very heavily on where a person lives.

In Ward 3, for example, there is an abundance of physicians, with “literally hundreds of doctors to choose from,” said Michael Williams, chief of health-care operations for the nonprofit D.C. Primary Care Association. But he said only 90 doctors list a business address east of the Anacostia River.

The District has a “severe mal-distribution of physicians” rather than a shortage, given that roughly 23 percent of the population lives east of the river but only a tiny fraction of physicians have a business location there, he said.

The board’s report found that, among actively practicing doctors:

●10 percent plan to leave the workforce through retirement, a move out of the District or a reduction in patient hours;

●The largest numbers that planned to leave the workforce are in internal medicine and cardiology;

●72 percent do not live in the District;

●More than 40 percent do not speak a foreign language;

●About 38 percent say more than 25 percent of their practice is made up of Medicaid patients.

Health officials across the country have been scrambling to prepare for the strain on the health-care system, particularly among primary-care providers, when millions more newly insured people gain access to care, assuming that the federal health-care overhaul law stays on track.

Nationwide, there are not enough primary-care doctors to meet needs. By 2015, the Association of American Medical Colleges predicts, the country will be short 29,800 primary-care physicians. In the District, primary-care doctors are those in internal medicine, obstetrics and gynecology, pediatrics and family practice.

Adding to demand for care in the District is the number of Maryland and Virginia commuters who see doctors in the District.

“A lot of physicians are not serving District residents,” said Jacqueline Watson, the board’s executive director.

But officials don’t know how many non-District residents are seeing doctors in the District. Nor do they know how many doctors are accepting new patients or how the changes in health care will affect demand for doctors.

“We have a lot of people with insurance who are not able to access those providers,” Watson said. “We have a demand issue already, and I can’t fully explain how [the health-care overhaul] will further impact that.”

Health officials in Maryland and Virginia say the numbers of doctors in their states are comparable to levels elsewhere in the country. Maryland’s Eastern Shore, along with the southern and western parts of the state, has a significant shortage of primary-care physicians, according to Ben Steffen, interim executive director of the Maryland Health Care Commission.

In Virginia, rural regions tend to have fewer doctors compared with metropolitan areas. Virginia’s southern, southwestern and eastern regions tend to have lower doctor-to-population ratios, officials said, and urban centers also tend to be underserved.

In the District, Watson said the survey is a first step and already provides a level of detail that did not exist in previous national surveys. Two more surveys are planned by 2014, and officials hope by then to provide a comprehensive picture of the physician workforce in the District.

Officials are presenting the report Wednesday at a physician workforce conference at George Washington University.

The survey was given to eligible physicians and physician assistants who were renewing their licenses in the District from Oct. 1, 2010, until Dec. 31, 2010, and also this year, from Jan. 1 to Feb. 28. About 8,940 doctors applied for renewal, and about 78 percent, or 6,945, took part in the survey.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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