Ohio addresses shortage of doctors
MARIETTA – Dr. Dinh Vu had just finished up his residency at Robert Wood Johnson University Hospital in New Jersey when he decided to bring his family practice skills to Marietta.
“I was working through a recruiting firm at the time and found Marietta,” he said. “I had asked to be placed in a small community because I grew up in a small town and wanted to get back to that. But I also wanted the capacity for growth and needed to be within a comfortable driving distance from a major airport.”
With a nationwide shortage of primary care physicians, especially in rural areas of the U.S., Vu had his pick of locations throughout the country, but he said Marietta fit the bill.
“It was perfect. The Marietta and Parkersburg area population was around 65,000 and is located within driving distance of two major airports,” he said.
According to the latest statistics from the U.S. Department of Health and Human Services, there are currently about 5,900 designated primary care Health Professional Shortage Areas (HPSA) across the nation. That means one in five Americans lives in one of the areas.
HPSAs are determined based on a ratio of one physician per 3,500 people, and Health and Human Services estimates it would take approximately 7,550 additional primary care doctors to eliminate the current nationwide shortage.
That number is likely to grow in the next year as millions more newly-insured Americans are expected to become covered under the federal health care law in 2014.
One HPSA currently exists in Washington County, according to HHS data. That includes the village of New Matamoras and the surrounding Grandview, Independence, Liberty and Ludlow townships.
New Matamoras Emergency Squad Chief Fred Hupp said a physician is made available in New Matamoras on a certain day each week but the community has no full-time doctor, which is a problem for area residents who need medical care.
“Most people have to drive all the way to Marietta for physician care, and some don’t have the transportation to get there,” he said. “And we do get calls from people who want to be transported to the hospital for a runny nose or other minor problem – to use us like a taxi service.”
Hupp said the squad members do not diagnose illnesses for patients.
“We tell them they should see their physician,” he said.
But many people – even those with better access to primary care physicians – don’t have a family doctor to whom they can be referred when they need medical attention, and finding a doctor or making a timely appointment can be a problem.
A new program has been initiated at the Memorial Health System’s Physicians Care Express facility in Belpre to help cover those situations, said Jennifer Offenberger, director of marketing and public relations for the Memorial Health System.
“We do recognize there can be a bit of an access issue,” she said. “So starting (July 1) in Belpre we’ll offer a new service called Care Connection Services.”
She said people who call the health system’s physician referral line but can’t be placed immediately with a doctor will be referred to Dr. Joy Chesnut at Care Connection Services.
“She will be able to begin their care, and once stabilized the patients will be referred to a physician that can meet their needs,” Offenberger said.
Chesnut, 41, a native of Puerto Rico, said she was also looking for a small-town atmosphere after serving her residency.
“I knew when looking for a job that I didn’t want to live in an urban area because I had always lived in urban areas,” Chesnut said. “There was a great need for primary care throughout the country, and the doors were open for anywhere I wanted to work.”
She accepted a position at the former St. Joseph’s Hospital in Parkersburg, where she worked as a primary care physician for 10 years before recently joining the Memorial Health System.
“Marietta is the first system I’ve seen that has been trying to actively address the primary care issue,” Chesnut said. “And because the need for primary care doctors is so large some doctors can be selective about the patients they receive. It’s a supply and demand issue that can create inequities for patients.”
She said her vision is to provide temporary primary care for patients who need immediate attention so they’re not trapped in that situation.
“We’re trying to generate a model to address this growing need,” Chesnut added.
Nationwide, bills seeking to expand the scope of practice of dentists, dental therapists, optometrists, psychologists, nurse practitioners and others have been killed or watered down in numerous states. Other states have proposed expanding student loan reimbursements, but money for doing so is tight.
As fixes remain elusive, the shortfall of primary care physicians is expected to grow.
The national shortfall can be attributed to a number of factors: The population has both aged and become more chronically ill, while doctors and clinicians have migrated to specialty fields such as dermatology or cardiology for higher pay and better hours.
But there are exceptions.
In January Vu, 34, joined the Memorial Health System as a family practice doctor at the Physicians Care Express facility on Pike Street.
“He chose to come here and practice primary care, but he’s getting married in August, and his wife, also a primary care physician, is moving here to set up practice. They both fell in love with this area,” said Offenberger.
She said the system has added 10 new primary care physicians in the past year.
Approximately 150 physicians, including primary care and specialists on both sides of the Ohio River are part of the Memorial Health System, according to Tammy Cinalli, the system’s director of physician recruitment and development.
She said the department recruits from a board-approved list of physicians, focusing on specialties that may be lacking in this area.
“But we also work to fill any vacancies from retirements or physicians who may have moved out of this area,” Cinalli said.
She said potential hires are found in a variety of ways.
“The newer generation may access us through websites, and we do subscribe to several of those,” Cinalli said. “Others (like Vu) come to us through headhunters. But we also try to keep in contact with students from this area who may be pursuing a medical school education, which means we’re looking ahead eight or 10 years.”
About half of the students from this area who are headed into the medical field are interested in returning to practice in their hometown, she said, adding that the health system stays in contact with those people throughout their college years, hoping they’ll choose to set up a practice locally.
Cinalli, who’s been recruiting doctors for the last 14 years, said salary doesn’t come into play when interviewing potential physicians.
“We use a national benchmark when we interview, and salary is not a factor in those interviews,” she said. “But salaries here are compatible with other areas, and in some cases they are even better.”
Vu also noted the cost of living can come into play.
“I live in a very nice apartment here that’s half the cost of the place I lived in New Jersey,” he said.
The Associated Press contributed.