Saturday, February 7, 2004

600 doctors needed in rural counties

UK study suggests coal tax revenue to lure physicians

By Roger Alford
The Associated Press

HAZARD, Ky. - A study by the University of Kentucky Center for Rural Health found that the state needs an additional 600 doctors to meet residents' health needs.

Only 15 counties in Kentucky have enough family physicians, the study said. It recommended using a portion of coal severance tax revenues to repay student loans of physicians who agree to practice at least five years in poor counties.

Judy Jones, director of the Center for Rural Health, said family physicians not only contribute to the health but also to the economies of small communities, which is an objective the state tries to meet with coal severance tax revenues.

"It's an unconventional economic strategy," Jones said. "But compared to trying to bring in a small factory, it's not expensive, and it could provide great benefits, even beyond what manufacturing can provide."

Gov. Ernie Fletcher shares the concern that too many doctors are leaving Kentucky to practice elsewhere, Fletcher spokesman Wes Irvin said in a statement.

"This medical crisis is placing patients at risk, especially those folks who are left without a doctor's care in rural Kentucky. That's why Gov. Fletcher is working with Sen. David Williams to pass comprehensive medical malpractice reform that will ensure we keep and attract more doctors across Kentucky," Irvin said in the statement.

He did not comment on the severance tax idea.

The study was headed by Dr. Baretta Casey, director of the East Kentucky Family Practice Residency Program in Hazard.

Casey said the state's rural medical residency programs can be expected to produce only 16 to 18 new family physicians each year. In addition, Casey found that interest in family medicine at the University of Kentucky and many other colleges and universities across the country has waned in recent years.

"It stands to reason that as medical education costs increase so does student debt - a factor that has influenced many students' decisions to select specialties much more lucrative than family practice," Casey said in a written report that will be presented to legislators.

Casey said researchers found that keeping family physicians in rural counties can be difficult because of a workload that is far heavier than in metropolitan areas, and because of the increasing cost of medical malpractice insurance.

"About 70 percent of all Kentucky physicians saw a rise in insurance premiums in 2002, ranging from 40 to 64 percent spikes for obstetricians and internists to more than 200 percent increases for emergency physicians," he said.

Casey said the osteopathic medical school in Pikeville will boost the number of primary care physicians in rural counties.

The Pikeville school's first 53 graduates will complete their residencies in July, with more than half planning to practice in Kentucky.

Rural family practice programs, including the one at the Center for Rural Health, have produced 187 physicians, with 125 who practice in rural areas.

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