Community officials confront doctor dearth

Friday, March 21, 2008

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Staff photo by KAYLEIGH KULP
Vinod K. Shah, left, owner of Shah Associates with practices in St. Mary’s and Calvert counties, and Chinnadurai Devadason, Charles County health officer and president of the Charles County Medical Society, discussed solutions to Southern Maryland’s physician shortage Tuesday.

The business community will be the key to pushing legislators into action to solve Southern Maryland’s dire doctor shortage, officials said in a panel discussion at the Waldorf Jaycees center Tuesday night.

‘‘I don’t think they’re listening to the physicians. But I do think they’re listening to the business community,” said moderator Carol A. Paris, president of the St. Mary’s Medical Society. ‘‘The business community needs to know premiums aren’t going up because doctors are making more money.”

The forum, hosted by the Maryland State Medical Society, addressed the study released in January by MedChi and the Maryland Hospital Association that determined the state’s physician shortages. They are likely to worsen as ‘‘baby boomer” doctors retire, the aging population increases, the state fails to retain young medical school graduates and insurance payments to doctors remain low.

Calvert, St. Mary’s and Charles counties lack doctors in 27 of 30 medical categories including primary care, emergency medicine, anesthesiology, cardiology, general surgery and oncology, the study found. Maryland overall is 16 percent below the national per-capita average of practicing physicians.

The state’s created a ‘‘hostile” and ‘‘toxic” environment for physicians in many ways, including low private insurer payments compared to the national average and cost of living, and expensive medical liability insurance, all of which make physicians hard to attract and retain in the state, panelists said.

Business leaders have better leverage against lawmakers to implement tort reform, regulate insurance companies and emphasize the demand of their workforce for adequate health care services.

‘‘We are having a problem because our system is broken,” said Vinod K. Shah, owner of Shah Associates, a large practice with offices in Calvert and St. Mary’s counties.

‘‘It strikes me as, this is a basic, economics 101 issue,” said Bob Schaller, director of St. Mary’s County Economic Development Department. ‘‘At the end of the day, it has to be worth it to you. I don’t think the business community knows what is at stake here,” noting availability of quality health care could weaken, and the cost of employee health care for business owners could increase as a result.

‘‘Many people and business leaders aren’t aware of your dilemma,” Dan Barufaldi, CEO of the Charles County Chamber of Commerce, told attendees. Barufaldi said the cost and availability of good health care are major factors businesses ask him about when considering relocating to Charles. He invited attendees and officials to make a presentation to the chamber’s health care council and join forces to bring awareness to the community.

James Delligatti, chairman of the board of directors for St. Mary’s Hospital, agreed the message would be made most effectively through chambers of commerce.

‘‘I would’ve liked to see more businesspeople in this room. The amount of understanding as to what goes on with physicians is very low. We’ve all been patients and will be patients in the future,” he said.

But Chinnadurai Devadason, Charles County health officer and president of the Charles County Medical Society, said leadership needs to come from the physicians, who need to ‘‘speak with a collective voice.” Schaller added, ‘‘You are the business community too,” and urged physicians and business leaders to work together.

Panelist Sylvia Batong told attendees about having spent over a decade in school to become a doctor and partnering in a Calvert County general practice – only to find she made her peak income 12 years ago and in 2000 had to take on a second job at an urgent care facility.

‘‘I was better off working an hourly rate for someone else. Forty-four percent of my income came from the urgent care provider, which was 40 hours a month,” she said.

Batong eventually left her practice because malpractice insurance premiums, low insurance reimbursement payments and costs of necessary technological advancements couldn’t make ends meet.

‘‘I felt like I was working for everyone else. My revenues were constricted to forces beyond myself,” Batong, who said her overhead costs were 65 percent of her revenue when she left. ‘‘It’s hard to get bigger when you don’t have enough money to feed yourselves. We’re loyal to our patients so we don’t want to turn them away because their insurance doesn’t reimburse as well.”

Heidi Mattingly, practice manager for Southern Maryland Orthopedic and Sports Medicine, said her practice has lost dozens of qualified candidates for orthopedic surgeon jobs to metropolitan areas and other states.

‘‘There isn’t a consumer in this state that would tolerate a 10 percent decrease in pay each year and stay. You can’t continue running your business if you can’t predict your cash flow,” she said.