Florida projects worsening doctor shortage

Florida now can put hard numbers to what it knew anecdotally about a looming physician shortage.

The state's physicians are aging: About 64% are 46 or older. Also, 13% of Florida physicians plan to reduce significantly their scope of practice or leave medicine in the next five years, according to the Florida Dept. of Health's 2008 Florida Physician Workforce Annual Report (link)

Liability and reimbursement were the top two reasons doctors cited for changing their practice outlooks.

"While not surprising, these statistics should be sobering for policymakers," the Florida Medical Assn. said in a statement.

State lawmakers mandated that the health department conduct an annual survey of physicians renewing their licenses. There was a 99% participation rate for the inaugural report. All of the state's 4,839 osteopathic physicians participated through the license renewal. Nearly half of the state's more than 50,000 allopathic physicians renewed their licenses in 2008, with most participating in the survey.

"This first survey is an excellent opportunity for the state to delve into the data and come up with solutions," said Jessica Swanson, the health department's program administrator.

Among the survey findings:

• 31% of doctors take emergency call or work in an emergency department. Among these physicians, 78% were specialty on-call physicians and 22% were full-time emergency physicians.
• 40% of doctors practicing obstetric care said they delivered babies.
• More than 14% of physicians who provide obstetric care said they would discontinue it in the next two years.
• Nearly 18% of radiologists who read mammograms or other breast imaging exams said they would decrease or discontinue that part of their practice.

Too little reimbursement, too much bureaucracy

The FMA said several factors have led to the shortage, including poor Medicare and Medicaid reimbursement rates, exorbitant professional liability insurance costs, burdensome bureaucracy that managed care dictates, a growing number of elderly patients and a shortage of residency slots.

"It is our hope that the state Legislature will work with us to find creative solutions to make Florida a more friendly place for physicians to practice medicine," the FMA said. "Creating an environment that will attract and keep physicians in our state is sound policy and an important step in ensuring Floridians have access to care for both today and tomorrow."

Florida is among several states that released work force studies in 2008. Wisconsin, Massachusetts and Connecticut are among those that need more doctors, particularly primary care physicians. November 2008 reports from The Physicians' Foundation and the American College of Physicians also projected primary care shortages across the nation.