Printed in Kansas City Business Journal – Read the article here

By Rob Roberts on October, 17, 2008

The Kansas City area is headed for a doctor shortage of epidemic proportions.

Therefore, leadership of the Metropolitan Medical Society of Greater Kansas City, an 800-member physician advocacy group, is prescribing heavy doses of recruitment during the next 10 years.

In that span, 40 percent of the roughly 4,400 doctors now practicing in the metro area are expected to retire, according to a survey
scheduled to be presented during the group’s Oct. 16 annual meeting. Jill Watson, executive director of the organization, said the
survey gauged the local physician work force’s ability to keep up with the health care demands of aging baby boomers.

The results were “scary,” said Dr. Steve Reintjes, a neurosurgeon and president of the medical society.

“News of this looming shortage comes at a time when practicing physicians are already having a difficult time recruiting,” Reintjes said.

The survey found that 44 percent of the 393 respondents said they have open positions in their practices and that 74 percent said they anticipate the need to recruit doctors in the next five years.

Unless remedies are found, Reintjes said, patients will face longer waits to see primary-care doctors and “exceedingly long waits” to see specialists.

“There also will be a profound economic impact,” he said. “Doctors are an essential component of the local economy because of the people we employ, the taxes we pay and the charitable contributions we make.”

Watson said the survey determined that area practices employ 21,000 full-time and 3,200 part-time employees. Combined with the doctors, that accounts for $2.7 billion in annual payroll.

In the next few weeks, Watson said, the medical society will release the final portion of the survey, which focuses on the insurance reimbursement rates received by local doctors relative to rates paid in surrounding markets. Past surveys have shown that local reimbursement rates contribute to the recruitment problem, and some comments in the new survey suggest that remains the case.

Fifty-nine percent of the doctors surveyed said they found it highly difficult to recruit new doctors, and one said it was because of reimbursement rates that are 20 percent to 30 percent less than those paid in Nebraska and Oklahoma.

“I no longer believe it is ethical to attract a new physician to Missouri,” another doctor wrote. “Malpractice insurance in Kansas is so much better.”

Reintjes said malpractice lawsuits filed in Missouri had declined 60 percent since the enactment of tort reform in 2005. Consequently, malpractice insurance premiums on the Missouri side have decreased between 10 percent and 30 percent, he said.

Still, doctors who live and practice on the Missouri side pay twice as much for malpractice insurance as their Kansas counterparts.

The difference, Reintjes said, is that Kansas doctors buy only the first $200,000 of malpractice coverage from private carriers and are covered beyond that level through the Kansas Health Care Stabilization Fund, which spreads risk among all doctors in the state.

Reintjes serves on a board appointed by Gov. Matt Blunt to study the feasibility of creating a similar fund in Missouri, which could help recruitment, he said.

In the meantime, the medical society will pitch students, residents and doctors in other cities on this area’s quality of life, low cost of living, highquality hospitals and other selling points.

The society soon will launch a Web site in conjunction with the Kansas City Area Development Council and the Kansas City Area Life Sciences Institute Inc. It will target current and future doctors who want to participate in clinical research.

Watson said the new survey found that a surprising number of local doctors — 26 percent — participate in cutting-edge trials and other clinical research. That probably is due to the area’s heavy concentration of research assets, such as the Stowers Institute for Medical Research, the University of Kansas and University of Missouri-Kansas City medical schools, Kansas City University of Medicine and Biosciences, and one of the nation’s highest concentrations of contract resource organizations, which help conduct trials of new therapies.

Bill Duncan, president of the Kansas City Area Life Sciences Institute Inc., said that attracting more physician/researchers will do more than mitigate the looming doctor shortage. A large physician/researcher population also has been deemed a missing link in the effort to translate more locally generated basic research into commercialized health care products and services.

“The more physicians we have involved in research, the better our quality of care is going to be and the better our citizens’ access to cutting-edge treatments is going to be,” he said. “So it seems (the physician recruitment effort) will be beneficial to all parties involved.”

How bad is it, doc?

A survey commissioned by the Metropolitan Medical Society of Greater Kansas City indicates that local physician practices may be inadequately staffed to deal with rising demand for health care. Some highlights:

  • 40 percent of the area’s 4,428 physicians — 1,771 doctors — plan to retire within 10 years.
  • 44 percent of local practices have physician openings; 74 percent expect openings within five years.
  • 59 percent of local doctors think recruiting new doctors to this market is highly difficult. | 816-421-5900