Daily Independent (Ashland, KY)

June 28, 2013

Needed: Doctors

Kentucky projected to need at least 3m790 more physicians

The Independent

ASHLAND — With an additional 600,000 Kentuckians expected to qualify for Medicaid or private insurance as a result of the Affordable Health Care Act, or Obamacare,  a report from Deloitte Consulting estimates the state will need 3,790 additional physicians with the greatest need for more primary care doctors being in rural counties where it is most difficult to convince physicians to locate.

And the need is not just for more physicians. The same report also estimates there is a need for 612 more dentists, 5,635 more registered nurses, 296 more physician assistants and 269 more optometrists.

The bottom line is this: While more Kentuckians  than ever are likely to have either Medicaid or private insurance to pay for their health-care needs, they may have difficulty finding doctors and health-care professionals to meet those needs.

Thousands of more Kentuckians are expected to qualify for Medicaid beginning in 2014 under Obamacare. While the federal government will pay for the additional cost of that expansion for the first four years, its impact on the quality care for the state’s poorest families will be limited if they can’t easily get to doctors. Some predict it will be months before some can get a doctor’s appointment  and some residents may have to drive many miles to see a doctor.

The administration of Gov. Steve Beshear also hopes the Kentucky Health Benefit Exchange will enable more Kentuckians to afford health insurance. If so, that will also increase the need for more doctors.

The University of Pikeville’s College of Osteopathic Medicine has done a tremendous job of training doctors who stay in the mountains, and a cooperative program offered by the University of Kentucky’s College of Medicine and Morehead State University enables medical students who plan to concentrate on rural medicine to receive at least a year of their medical training on the MSU campus. While those two programs are helping to bring more physicians to the mountains , they are  unlikely to be enough to meet the need even if every doctor completing the two programs remains to practice in the mountains.

As a result, state officials are looking to expand the loan-forgiveness programs for doctors who set up practices in underserved areas, a program that convinces young doctors to practice in rural areas for at least a few years. And the state and local governments as well as rural hospitals and health clinics are looking at ways to recruit more international medical graduates into rural communities. Say what you want about immigration, the doctors who have been recruited from foreign countries have had a tremendous positive impact on the quality of medical care available in eastern Kentucky. We think most area residents would welcome more foreign-trained doctors.

But in the final analysis, UPike and the UK-MSU programs have the best idea. Doctors born and trained in this region are among those most likely to stay here for their entire careers. Not having enough doctors is an inadequate reason for refusing to expand Medicaid and to  offer more affordable health insurance to Kentuckians. It simply is a challenge that,  if not met, could limit the positive benefits of those changes.