An annual survey of New York hospitals has found the state”™s physician shortage continued to grow in 2010, leaving rural communities especially underserved. Westchester County and the New York City suburbs generally fared better than other regions of the state.
The Health Association of New York State (HANYS) surveyed 109 of its member hospitals outside of New York City. Hudson Valley hospitals in the Northern Metropolitan Hospital Association (NorMet), including Westchester institutions, participated in the survey.
The highest ratio of physicians to population was reported on Long Island and the lowest was in the Mohawk Valley.
Nearly 2,300 physicians retired or left hospital medical staffs in 2010, up from 1,600 departures in 2009.
An estimated 510 physicians were expected to retire in 2011. With the average age of practicing physicians in the state at 52, and with 16 percent of physicians over the age of 65, the pace of retirements is expected to accelerate in coming years, exacerbating the shortage, HANYS officials said.
The shortage will be most acute in rural counties, in 20 of which the percentage of doctors over 65 is higher than the statewide percentage. In 11 counties, more than 20 percent of practitioners are over 65.
Two out of three hospitals in the survey reported the doctor shortage at times left their emergency departments without coverage for some specialties and patients had to be transferred for treatment at other hospitals.
About one out of three hospitals reported that they had to reduce or eliminate services in 2009 and 2010 due to physician shortages.
Hospitals surveyed said they need 763 additional physicians. Of that need, 18 percent is for primary care, a percentage much higher than the proportion of graduating medical residents that choose the primary care field, HSNYS officials noted.
That need is driving up physician employment by hospitals, “making the future of small group and individual practices uncertain,” HANYS officials said. New York hospitals reported that 37 percent of new physicians in 2010 were hospital employees rather than independent practitioners. Of the hospital hires, 16 percent were in primary care and 16 percent were hospitalists.
The 3,038 physicians that joined hospital medical staffs in 2010 represented a net overall gain from the previous year. Those gains, though, were largely limited to the downstate region.
Of the total number of physicians hired, 36 percent were on Long Island and 25 percent were in Westchester and the Hudson Valley region. The rest of the state gained a little more than 100 physicians in 2010.
Hospitals statewide reported that psychiatrists, urologists, orthopedists, internal medicine sub-specialists, obstetrics/gynecology and primary care doctors were most difficult to recruit. Recruiters often were thwarted by an inability to offer a competitive salary, a dearth of candidates, the hospital”™s geographic location and lack of employment opportunities for physicians”™ spouses.
In Western New York, 55 percent of hospitals surveyed said recruiting had become more difficult, compared with 24 percent statewide.
Four out of 10 hospitals surveyed in this Hudson Valley region said their ability to recruit physicians had declined.
“Our problem is recruitment and at times retention,” said Kevin Dahill, president and CEO of NorMet and the Nassau Suffolk Hospital Council. “It”™s tricky to get them here because of the cost of living. Sometimes when they see the tax structure and the housing issues, they get panicky.”
