2 Panels Address Physician Shortage

State and local medical officials are working on two reports on ways to deal with a severe physician shortage in Southern Maryland that is predicted to get worse, with many area doctors expected to retire by 2015.

The collaboration stems from a report this year by the Maryland Hospital Association and MedChi, the Maryland State Medical Society, warning of dire shortages. Medical professionals said they were shocked by the severity of the problem.

Charles, Calvert and St. Mary's counties have "critical shortages" in 25 of 30 physician categories, leaving Southern Maryland with 44.4 primary-care physicians for every 100,000 people, which is well below the state average of 57, according to the report.

Although Southern Maryland is expected to experience the most serious doctor shortages in the next several years, Western Maryland and the Eastern Shore also face serious problems, medical officials said.

Physicians, elected leaders and hospital administrators from the three regions are serving on two task forces, the Task Force to Review Physician Shortages in Rural Areas and the Task Force on Health Care Access and Reimbursement. The panels are expected to present recommendations to the governor this year.

"There's no question that this is an issue that must be addressed now," said Nancy Fiedler, a spokeswoman for the Maryland Hospital Association. "We need to find some real immediate solutions for the state's rural communities."

The state Task Force to Review Physician Shortages in Rural Areas is being headed by Sen. Thomas M. "Mac" Middleton (D-Charles), who has pushed for higher insurance reimbursements for physicians.

The presidents of Civista Medical Center in La Plata and St. Mary's Hospital in Leonardtown are also on the task force. Civista President Christine M. Stefanides heads a subcommittee that will compile short-term ideas for addressing the physician shortage.

In April, the presidents of the three county hospitals in Southern Maryland announced that they would join a program called Maryland eCare, which uses physicians based in Delaware to electronically monitor intensive-care patients and help compensate for the shortage of critical care physicians in rural areas of the state.

"We have a problem, and we're trying a host of different things to fix it," Stefanides said when the program was announced.

The Maryland Hospital Association and MedChi have had a series of meetings in the most affected areas of the state to warn about the ramifications of the severe shortages.

A major goal is to increase the number of student slots at the state's medical schools, but the effects of that might not be seen for 12 years, Fiedler said. Also, increasing the number of medical students does not ensure that they will take jobs in Maryland. Recent figures show that 54 percent of Maryland medical school graduates accept jobs in the state. Doctors say that number could decrease.

Insurance reimbursement rates are a major obstacle to making Maryland "physician-friendly," officials say. The state is in the lowest quadrant for physician payments nationwide. Medicaid reimbursements for those who cannot afford private insurance also fall below national averages, creating little financial incentive for physicians to treat those who often need care the most.

Rural areas pose even more challenges for attracting and retaining physicians. Although most parts of Southern Maryland offer easy access to a major metropolitan area, many physicians are discouraged by practicing in small areas with fewer amenities.

"It is really something that requires broader awareness of all the factors at work, so that we can look at the entire problem," Fiedler said.

The two task forces are expected to present their recommendations to the governor and General Assembly by Dec. 1.