Physician shortage affects El Paso, Teller counties

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Baby Boomers are getting older and retiring.

That means that physicians who are Baby Boomers are doing the same.

“Nationally, there’s already a [physician] shortage of about 20,000 that’s supposed to grow between now and 2025,” said Dr. Mike Ware, executive vice president of the El Paso County Medical Society. The EPCMS is affiliated with the Colorado Medical Society and the American Medical Association.

“As a community, we are short physicians,” said Dr. Gil Porat, Penrose-St. Francis Health Services chief medical officer.

Approximately 1,100 physicians — including primary care and specialties — practice medicine in El Paso and Teller counties, Ware said. The region, which includes southeastern Colorado excepting Pueblo and its suburbs, has 213.2 physicians per 100,000 citizens, according to the Dartmouth Institute for Health Policy and Clinical Practice. The Association of American Medical Colleges said the national average is 220 physicians per 100,000 citizens.

Primary care physicians

The number of primary care physicians in El Paso County is significantly lower than it is statewide and in other counties, specifically Boulder and Denver counties.

According to a 2010 county rankings study by Robert Wood Johnson, there are about 56 primary-care physicians practicing in El Paso County per 100,000 patients.

That compares with 122 primary care doctors practicing for every 100,000 persons in Boulder County, 117 in Denver County and 80 practicing for every 100,000 persons in the state, according to a county rankings study by Robert Wood Johnson.

“We’re 40 percent below the national average of what is the recommended amount of primary care providers,” Ware said.

What this means for patients is that it will likely take more time to see a primary care physician than in Boulder or Denver, Ware said.

“We are experiencing a shortage in primary care, particularly in the adult care — family practice and internists,” said Dr. David Hoover, who practices with the Mountain View Medical Group.

Mountain View has 46 physicians and 20 nurse practitioners and physician assistants. The group has four job openings for primary-care doctors.

“One position has been open six months,” Hoover said. “We fill one position and then another position opens.

“It’s like playing bop-a-mole,” Hoover said.

Mountain View Medical Group is not recruiting physicians with specialties, he added.

Specialists

What’s been termed a “major issue” in the community is the shortage of psychiatrists practicing in El Paso County, Ware said.

“My board of directors asked what is the biggest need in our community, and the answer is mental health,” Ware said.

At Penrose-St. Francis, Porat agreed, saying, “In town, primary care physicians have a hard time finding psychiatrists to refer to.”

In Colorado Springs, only 9.1 psychiatrists practice per 100,000 citizens, whereas the U.S. average is 14.5 psychiatrists per 100,000 residents, according to the Organization for Economic Cooperation and Development and the Dartmouth Atlas of Health Care.

Porat said other specialties needed in the Colorado Springs area include primary care, rheumatologists (doctors who deal with arthritis), and endocrinologists, physicians who deal with the hormone system.

Productivity killers

A discrepancy exists between older physicians and younger ones, Porat said.

“There are productivity killers coming up,” Porat said, referring to demands on new documentation required. “There are more forms, and more you have to put into computers.” While the requirements are positive changes in the industry, “they slow doctors down. You’re just not as productive as you were in the past.”

Also, the aging population will accumulate medical problems more than the young, Porat said.

Young physicians entering medicine today also have different lifestyle expectations, he said.

“I think the modern physician expects to have more time with the family, less time at the hospital and on call,” Porat said. “As a result, you have to have more physicians covering the same job as in the past.”

“It’s a small factor, but you put all those things together — pay disparity, aging populations — it can add up.”

Adding to the physician shortage is the probability of more patients because of the Affordable Care Act, or Obamacare, which seeks to insure the previously uninsured, Porat said. It goes into effect Jan. 1.

“We do think there will be a lot more people with insurance. I think it will happen,” Porat said.

Recruitment

In the past, it wasn’t difficult to recruit physicians, because “with the geography and climate, it’s been relatively easy,” said Hoover.

But lately, physicians in specialties “can basically name where they want to go and they can name their price,” he said. “I know we are being out-bid.”

Some hospitals and corporations can offer signing bonuses of up to $20,000, whereas “Colorado Springs doesn’t have those kinds of resources,” Hoover said.

“The lack of a medical school and a lack of residency and fellowships has been a major problem with recruiting,” said Porat. “When we bring them to Colorado Springs, we are uprooting them from somewhere.”

The planned new branch medical school at UCCS will help, Porat said. But it falls short because there are no residency programs affiliated with the Colorado Springs branch. The medical school branch expects to enroll between 160 and 184 students, according to the University of Colorado website.

Porat cited himself as an example. He graduated from Colorado College, then went away for medical school and residency before returning to practice medicine.

At age 55, physicians tend to start cutting back on their hours in preparation for retiring, Ware said.

In Colorado Springs, the average age for physicians is approximately 52, he added. Also, 39.5 percent of the physicians in El Paso and Teller counties are 55 or older, he said.

“You don’t want to see that over 50 percent,” Ware added.