Peril seen in deficit of nurses, doctors
Posted on Wednesday, May 7, 2008
URL: http://www.nwanews.com/adg/News/224977/
Arkansas — which has one of the nation’s oldest and least healthy populations — is running short of doctors and nurses, creating conditions for a health-care crisis, doctors and experts told a legislative panel Tuesday.
State Rep. Gene Shelby, D-Hot Springs, who also is an emergency-room physician, proposed studying how to bolster the ranks of health-care workers, suggesting one option might be that the Legislature create a task force or committee to coordinate solutions.
Any such effort will have to come to grips with a physician population that is sparse, poorly distributed and aging, said Dr. Debra Fiser, dean of the College of Medicine at the University of Arkansas for Medical Sciences.
The state ranks 47 th out of 50 states and the District of Columbia in physicians per capita, Fiser said. And the ranks of the state’s doctors and nurses are graying — for example, more than two-thirds of the 21, 000 nurses are over age 40, said Claudia P. Barone, dean of UAMS’ College of Nursing, in testimony to the House and Senate Interim Committees on Public Health, Welfare and Labor.
Add to the mix a state that ranks in the top 10 for elderly populations and often ranks among the lowest states in various health indexes, Fiser said, and trouble looms.
“You’re going to have more demand and fewer physicians,” Fiser said. “This is not unique to Arkansas.... We just expect it may be somewhat worse here because we’re starting with so many unique and undesirable factors working against us.”
Across the country, especially in rural areas, hospitals are struggling to find enough doctors and nurses. The American Medical Association recently estimated that 85, 000 physicians would be needed nationwide by 2020.
An eight-state study concluded the same problems in Arkansas plague states as different as New York and Montana, said Michal Cohen Moskowitz, a program associate at the Associate of Academic Health Centers, an advocacy and research organization for medical schools and teaching hospitals in Washington, D. C.
Two years ago the group recommended increasing medicalschool enrollment nationwide by 30 percent by 2015 to meet increasing demand.
Arkansas ranks behind only New York and California in its medical-school graduates who remain in state, Fiser said, adding that UAMS, which broadened its available slots by 10 to 160 in 2006, wants to continue to increase its medical-school classes to 200 to narrow the state’s shortfall.
Fiser said the 40 slots could be added incrementally but would depend on funding.
A satellite medical campus in Fayetteville, due to open in 2009, would create more space as third- and fourth-year students do their rotations there, Fiser said. And new classroom space, added as part of a UAMS expansion, also creates enough desks for more students, she said.
Attempting to ease the nursing shortage, UAMS’ College of Nursing has admitted every qualified applicant for the past two years, Barone said.
But the nursing school can expand only as fast as it can hire and retain qualified faculty members, Barone said, adding that has become increasingly difficult, as instructors can make as much as $ 25, 000 more working in hospitals.
Sen. Percy Malone, D-Arkadelphia, said he would like to see UAMS examine its admission policies and give thought to expanding the entry of qualified applicants into the medical field.
Last year 160 medical students were selected out of 1, 200 applications, Fiser said.
“If we had more positions, we would be able to fill them with qualified applicants,” Fiser said.
Health-care payrolls across Arkansas came to $ 1. 6 billion for more than 42, 000 hospital employees last year, said Bo Ryall, executive vice president of the Arkansas Hospital Association.
Ryall said hospitals across the state complain of staffing shortages. Some have even resorted to offering unusual inducements to fill vacancies, he said.
“I noticed [a classified ad ] on Sunday. They were offering a flatscreen TV for new nurses to come to a certain hospital,” Ryall said.
Increasing the number of doctors and nurses in the state would be the financial equivalent of recruiting a major industry, he said.
“This is economic development,” he said.
Rep. Gregg Reep, D-Warren, said he appreciated Shelby’s efforts to collect data and find possible solutions to the problem.
“Obviously we’ve got a lot of jobs that need to be filled out there,” Reep said. “Ever since we’ve been in the Legislature, these issues keep hitting us between the eyes.”
Shelby said his study would attempt to collect reliable data on the shortage.
“We need to get a handle on where in the state and how severe our needs are. Right now there is no central organizing [body ],” Shelby said.