Virginia struggles to retain physicians

Virginia is having a hard time keeping its medical school graduates and medical residents.

About two in three graduates leave the state, making Virginia 31st nationally in retaining graduates, according to Assn. of American Medical Colleges' rankings cited in new state work-force figures. Sixty-one percent of residents go to other states after completing their training, the state said.

The problem will be compounded by increased demands for services for the aging population and coverage to the uninsured under the federal health system reform law, said Elizabeth Carter, PhD, director of the Virginia Dept. of Health Professions' Healthcare Workforce Data Center. The center released four reports in September that examined the state's physician work force.

"There simply aren't enough health care professionals in place or in the pipeline to serve the patient population there will be in 2014," said the Dept. of Health Professions Director Dianne Reynolds-Cane, MD.

Virginia is not alone. The nationwide physician shortage is expected to reach as many as 159,000 physicians by 2025. At least 22 states and 15 medical specialties had reported physician shortages as of June, according to the American Medical Association.

Virginia's Healthcare Workforce Data Center was created after a Sept. 2007 report by the state Health Reform Commission projected physician shortages to reach 1,500 physicians by 2020. Current projections suggest that the state, which has 22,215 practicing physicians, will be short 2,700 doctors by 2030.

More research is needed to determine why physicians are leaving the state, said William Harp, MD, executive director of the Virginia Board of Medicine. "We don't have that data yet."

Rural areas have been hit especially hard. Virginia officials estimate that 149 physicians and 23 psychiatrists are needed to serve the needs of residents in those areas.

The Edward Via College of Osteopathic Medicine in Blacksburg, Va., was founded in 2001 to produce physicians for rural and underserved areas, said Dixie Tooke-Rawlins, DO, the college's dean and executive vice president.

"You have to have somebody who is really driven to go to a rural area in the first place. They really need to be from a rural area," she said.

Virginia invested $50 million toward medical education in 2008. Three medical schools have increased their class sizes, and two new medical schools have opened. The number of medical graduates is expected to increase from about 425 this year to nearly 700 by 2015, according to the Healthcare Workforce Data Center (link).

Three Virginia hospitals also have added residency positions in the last two years, and two others are adding slots.