Covid-19, flu, RSV: Here are the vaccine recommendations for fall—and the best time to get them
No Luck Finding A Primary Care Doctor In Hampton Roads? You're Not Alone.
NORFOLK, Va. — If you're having trouble finding a doctor, you're not alone. There's a shortage of primary care doctors in Hampton Roads and across the country and the problem is growing.
Wednesday News 3 asked people in Hampton Roads how long it's taken them to find a primary care doctor and what the wait times for appointments are like.
"On average it's about three months to see my primary care manager," John Woodard of Chesapeake said. "At times it can be upwards of six months, depending on the time of the year, number of people in the area, the condition, the symptoms, etc..."
The wait can be worse if you're switching primary care doctors or dealing with insurance.
Virginia Beach
Landyn Davis speaks with News 3 as family prepares to leave hospitalJohn Hood
6:26 PM, May 01, 2024
"It took me a long time to get one. Like three years," said Shay Taylor of Norfolk.
News 3's reporter Erika Craven tried to make an appointment this week. Many doctor's offices weren't accepting new patients. One doctor's office that had openings said she'd have to wait until Feb. 2025.
Long wait times can be frustrating.
"Especially if you feel it's an immediate need issue. Three, four months down the line? You're not going to be sick three, four months down the line. You're sick today not tomorrow," explained Woodard.
"Healthcare is in a little bit of a crisis," said Dr. Steven Pearman, vice president and chief medical officer for primary care for Sentara.
The profession was hit during the pandemic.
Coast Live
Hampton University Proton Cancer Institute's Men's Health Fair on Coast LiveCoast Live
6:15 PM, May 01, 2024
"It was really hard for providers, physicians to get through COVID. There was this initial glow of like we're all heroes and then not too long afterwards there was the anger from patients," explained Dr. Pearman.
But the shortage doesn't just stem from COVID burnout. Dr. Pearman said aging populations with complex health needs put more demand on the system and retiring physicians and pay disparities mean there's a shortage of providers.
"Primary care in general is the lowest or one of the lowest paid specialties. The education costs are the same. The average debt coming out of medical school is about $250,000 so when people are making decisions on what they go into they choose one that's making more and that's pretty obvious. There is also a lack of graduate medical education resources for primary care, we're trying to improve that as well, but there's a disparity there," said Dr. Pearman.
The impact is felt in emergency departments and urgent care.
"How busy are these departments taking on some of the residual patients?" asked News 3 reporter Erika Craven.
Norfolk
Possible MacArthur Center redevelopment could take years to completeBrendan Ponton
5:18 PM, May 01, 2024
"It depends on the area but they are busy and many people use ER inappropriately, I would say. For things like a sore throat or urinary tract infection, it's probably ten times the cost it would be than if it were done in a primary care setting. So that's another concern; that we're increasing the cost of healthcare by using the ED as a primary care service," said Dr. Pearman.
Primary care, Dr. Pearman said, is the gateway to specialized care and is important to the health of the general population.
"The cost of care goes down the more primary care physicians you have, but also well-being goes up and death and mortality goes down. It's just because we're working on preventing things," said Dr. Pearman.
But the needed care is getting more difficult to come by, both in Hampton Roads and across the country.
Within a decade, reports suggest the U.S. Will be short at least 50,000 physicians. Moreover, last month's report from the Association of American Medical Colleges project the U.S. To face a physician shortage of up to 86,000 physicians by 2036.
Have You Seen Me
Police still seeking answers 7 years after mother, daughter disappearanceJessica Larché
6:00 AM, Apr 30, 2024
"If you think about 1,500 patients for every provider, that's [hundreds of millions of] people with limited access to primary care. That's scary," said Dr. Pearman. "But you can't do it the way we've been doing it. We have to do something differently."
News 3 first spoke to Dr. Pearman about the physician shortage last year. Since then, he said Sentara's been seeing some progress in addressing the problem. But, he added, nothing will change overnight.
He said Sentara's been working on a team care model to better allocate resources and working to keep new medical professionals in the area.
"Most of Virginia is paid lower than other parts . . . So if you're thinking about trying to hire and retain physicians and they're getting a lot less money for the work they do, it's harder to keep them. But we are working closely with EVMS, the nurse practitioner schools and we're looking at opening up some new residency programs around the area to really integrate our efforts," said Dr. Pearman.
In April Sentara rolled out an AI documentation tool that helps transcribe notes. Since then, Dr. Pearman said providers have seen a difference in workday efficiency.
Positively Hampton Roads
Nat'l Foster Care Month: VB nonprofit celebrates 10 years, holds open houseAnthony Sabella
10:17 AM, May 01, 2024
"By the time I leave my visit, I have my note done. That's huge. Takes a lot of time. You think of five minutes every 15 to 20, 30 minutes to document what you've just done, all these add up to another hour or two in your day. It gives us more time and capacity to see patients," said Dr. Pearman. He expects the tool to improve the work-life balance for medical teams.
Most places in Hampton Roads also offer telehealth.
"Telehealth is actually a lot faster than seeing someone face to face. So, I think they're bridging that gap between the waiting times. As a positive it works out really well for me because I get to do it on my time," said Woodard.
Since the shortage is expected to continue, Dr. Pearman added the best thing you can do is be patient.
"It's not because providers are not willing, it's because they are doing the best they can in a situation that's really [challenging] right now," said Dr. Pearman.
10:19 PM, May 01, 2024
9:47 PM, May 01, 2024
9:08 PM, May 01, 2024
12:44 PM, May 01, 2024
5:40 AM, May 01, 2024
11:45 PM, Apr 30, 2024
11:28 PM, Apr 30, 2024
5:27 PM, Apr 30, 2024
Copyright 2024 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
What If I Can't Find A Doctor? Physician Shortage Will Change How Americans Receive Care.
The most urgent threat to our health isn't a microscopic virus or strain of bacteria. It's a shortage of doctors.
A whopping 83 million Americans don't have sufficient access to a primary care provider. Within a decade, we could be short almost 50,000 primary care physicians.
Educating and training more doctors is critical, of course. But that will take years, even decades. In the meantime, we need to maximize the capacity of our existing corps of providers by making the health system more efficient and managing illness more proactively.
In other words, we have to learn how to do more with less. An ongoing revolution in digital health care delivery − from telehealth visits to pharmacies that deliver to the home − can help us do just that.
First, a reality check. The health care status quo isn't working for most patients. Seven in 10 Americans say the system isn't meeting their needs, according to data from a 2023 Harris Poll.
Patients may wait weeks for careThe United States faces a shortage of about 50,000 primary care doctors within a decade.
Wait times are the top concern. As a physician, I've seen firsthand how our system forces patients to wait weeks for care, even for the most routine and easily treatable health conditions. New patients wait 26 days, on average, to see a primary care physician. On the day of the appointment, the average patient waits nearly 20 minutes to see their provider.
Delays in care aren't just inconvenient. They have real-world consequences for patient health and the broader economy. Seeing a primary care doctor can prevent a manageable health issue from evolving into a life-threatening illness.
Telemedicine can help to bring efficiency to the sluggish status quo. Virtual appointments optimize doctors' time, allowing providers to see and triage more patients in a day.
How AI can help doctors treat patients: Your physician might not be listening to you. Artificial intelligence can help change that.
As an added benefit, virtually treating patients with routine health conditions can free up capacity at emergency rooms and other facilities focused on in-person care.
Patients benefit, too. Telemedicine eliminates the need to travel and can reduce how long patients have to wait for care. It's no surprise that virtual appointments are associated with fewer last-minute cancellations, which can sap a physician's productivity.
But how do we reconcile telemedicine with the continued need for in-person diagnostics and lab work?
Opinion alerts: Get columns from your favorite columnists + expert analysis on top issues, delivered straight to your device through the USA TODAY app. Don't have the app? Download it for free from your app store.
Integrating virtual care with remote patient-monitoring tools can help providers receive real-time updates on their patients' blood glucose, blood pressure and more.
That allows doctors to better monitor, communicate with and prescribe medicines for patients. One study found that remote patient-monitoring programs can reduce hospital readmissions by half.
Patients often don't take medicine they're prescribedEnsuring patients can take the medicines their doctors prescribe also will boost our health system's productivity. Too often, patients don't adhere to their recommended treatment regimens, which can allow manageable conditions to snowball into life-threatening emergencies.
Millions of Americans land in the hospital each year because of chronic conditions, which affect an estimated 6 in 10 Americans. Yet, for diabetes and high blood pressure, medication adherence rates are typically at 50% to 60% of prescribed doses.
Nonadherence results in more than $300 billion in avoidable health care costs in the United States every year. About 125,000 Americans die annually because of nonadherence.
Good news for patients: Florida can now import prescription drugs from Canada. FDA approval may help burst Big Pharma myths.
Making it easier for patients to take their medicines as directed with online alternatives to traditional pharmacies can help solve this crisis. One study of Medicare Part D patients with chronic conditions found that those who used pharmacy delivery services were significantly more likely to adhere to their prescriptions.
Consumers who hesitate to use mail-order pharmacy services are most concerned about delivery speed and a perceived lack of personal connection. Fortunately, several companies are working to address these potential roadblocks by delivering drugs faster and offering more personalized care.
Other consumers are discouraged from sticking to their medication when they pick it up only to find out at the pharmacy counter that it's more expensive than expected. Online alternatives often make prices clear upfront − and sometimes they're cheaper than going through insurance.
Better adoption of telemedicine and pharmacy delivery can streamline our health care experience, help providers who are stretched thin to triage care and make us healthier. It's time for our health care system to meet patients where they are.
Dr. Vin Gupta is a practicing pulmonologist who serves as chief medical officer of Amazon Pharmacy. He concurrently serves as a medical analyst for MSNBC and NBC News, affiliate faculty at the University of Washington's Institute for Health Metrics and Evaluation and a major in the U.S. Air Force Medical Reserve Corps, serving as the officer in charge of the Critical Care Air Transport Capability at Joint-Base Lewis McChord.
You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter.
This article originally appeared on USA TODAY: How can I find a doctor? Physician shortage is changing medicine
View comments
Free Med School Tuition Won't Solve The Shortage Of Primary Care Physicians
Last month, nearly 40,000 medical students were accepted into residency programs on "Match Day." Surrounded by family and friends, these soon-to-be-physicians opened envelopes revealing where they would begin their careers. This moment marked the culmination of a residency match process that requires medical students to make a series of choices and rankings about which medical specialty to practice and at which health system, along with the various lifestyle factors inherent in such a decision.
Each year, match data provide important signals into the desirability and workforce health of various medical specialties. For example, dermatology, anesthesiology, general surgery, and plastic surgery maintained their usual high fill rates, while more than 250 pediatrics positions and more than 600 family medicine positions went unfilled.
These results come as no surprise and are in line with a longstanding shortage of new physicians entering primary care specialties. To address these workforce gaps, medical schools are trying a new approach: tuition-free medical education.
In February, Albert Einstein College of Medicine was the latest program to become tuition free, thanks to a $1 billion gift from Dr. Ruth Gottesman, whose generosity and modesty in asking nothing — not even naming rights — in return for her donation should be applauded. This gift followed similar programs at NYU Grossman School of Medicine and Kaiser Permanente Bernard J. Tyson School of Medicine, among others.
There is no doubt that not having to pay tuition for medical school saves students from a crushing debt burden. This is no small feat. It may also help draw more applicants from underrepresented groups, although the jury is out on this outcome.
But a larger goal of freeing medical students from the burden of student debt is to enable them to pursue a wider range of specialties or geographies, minimizing the need to steer towards the highest-paying options in the biggest cities to pay off student loans. According to Einstein's website, the primary goal of the new program is to allow graduates "to choose their specialty based on passion and aptitude rather than financial obligation." One motivator for Gottesman's gift was her recognition of the challenge for students to choose primary care while saddled with educational debt. As one profile of her states, "the hope … is that [the gift] provides the opportunity to stay in a place like the Bronx and give care where it is needed." Similarly, NYU's dean of admissions suggested in a 2018 interview that the school's new tuition-free policy would create more primary care physicians to help address the national shortage.
Unfortunately, on training primary care physicians or sending graduates to underserved areas, tuition-free medical school gets an F.
NYU's 2024 residency match list shows that free tuition barely made a dent toward these goals. Last month, the third class to graduate with all four years of tuition-free medical school matched into residency. Only 14% of NYU's graduating class chose primary care specialties, far below the proportion of U.S. Physicians working in primary care (30%). This includes just 2 out of 107 graduating NYU students entering family medicine, despite 9% of medical school seniors nationally choosing this specialty. And NYU sent a lower percentage of its students into pediatrics (6.5%) than peer institutions without tuition-free policies, such as Johns Hopkins (7.4%) and the University of Pennsylvania (8.8%). Furthermore, nearly three-quarters of NYU's graduating students matched into programs in just three states — New York (59), Massachusetts (9), and California (8) — nearly all of them in big-name academic health centers in major cities.
Taken together, NYU's latest Match Day results are not meaningfully different from any other top-tier medical school without a tuition-free policy: The vast majority of students steer toward the usual-suspect specialties and health systems.
Medical school debt is just one factor in students' decisions about choosing a specialty or the location of their residency. And it may be more tangential than many think. Myriad other incentives induce medical trainees to avoid primary care and underserved areas, and these incentives are deeply and historically entrenched in the structure and culture of the U.S. Health system. Efforts to change these incentives indirectly — such as tuition-free policies — will be overwhelmed by the current choice environment facing medical trainees.
What really needs attention is the pay differential between primary care and specialty physicians. The average annual compensation for primary care physicians ranges from $250,000 to $275,000. Cardiologists, by comparison, average $507,000 and orthopedic surgeons average $573,000. Over a 30-year career, that pay difference is worth $7.5 million. Students don't have to be money grubbing to allow such financial considerations to influence their decision-making.
There's also the prestige factor to consider. Since the emergence of National Institutes of Health grants and fellowships after World War II, specialists have been the high-status faculty within academic medicine. Over time, this prestige has been reinforced by their higher reimbursement weights in the fee schedule used by Medicare and other payers.
Medical schools need to be more intentional about linking their training cohort to meet the nation's workforce gaps and care needs. An estimated 83 million people in the U.S. Live in areas without sufficient access to primary care. Studies show that a strong foundation of primary care yields better outcomes and equity, serving as the bedrock for addressing social drivers of health and managing complex patient care. Yet a record number of pediatrics residencies went vacant this year, and a record number of family medicine residencies went vacant last year.
If medical schools truly want to help improve primary care in the U.S., they need to create a better choice environment for medical students. Four investments can reshape incentives so more students go into primary care and underserved areas.
First, instead of free tuition with no conditions, medical schools should implement strings-attached loan forgiveness programs. All students would be given low-interest loans to cover all medical school costs. These loans are then forgiven for students who enter primary care, pediatrics, or psychiatry, or who work in underserved urban or rural communities. For each year of education financed, they must provide two years of this service. Students who choose orthopedics, dermatology, or other highly paid specialties must repay the loans with accruing interest, sustaining the overall funds. Loan forgiveness directly incentivizes students to make career choices that benefit underserved patients.
Second, more carefully target tuition-free policies. Very few medical schools can raise $1 billion, but many could raise $50 million or $100 million. By reserving the earnings of those relatively modest endowments only for students pursuing a handful of underserved specialties, other medical schools have an opportunity to affect the physician workforce crisis more directly than Einstein College of Medicine will. For example, NYU's Grossman Long Island School of Medicine is also tuition free, but it specializes in primary care medicine, with a focus on training students committed to careers in internal medicine, family medicine, pediatrics, OB-GYN, and general surgery. Two weeks ago, 67% of its graduating class decided to enter primary care residencies, and many have chosen to stay local, a sharp contrast with the residency results of NYU's main campus.
Third, publicly support policy efforts that increase pay for non-procedure based clinical activities, one of the few mechanisms to decrease the enormous pay disparity between primary and specialty care. For example, new Medicare billing codes have been proposed to better reimburse physicians for complex patient office visits, but they face consistent resistance from specialist lobbying groups.
Fourth, expose students to primary care earlier and put more emphasis on team-based care in medical school. By changing the culture around primary care — such as emphasizing primary care's central role in complex care management — more students will properly associate it with impact and engagement.
By covering every student's tuition with no conditions, Einstein College of Medicine is hoping more of its students make public-spirited career choices. But come Match Day, its students will face the same pressures as other medical school graduates, steering them away from areas of medicine that can do the most good. More intentional and structural solutions are needed to alter the choice environment in medical education and better link graduating physicians with growing patient care gaps.
Ezekiel J. Emanuel is an oncologist, vice provost for global initiatives, and co-director of the Healthcare Transformation Institute at the University of Pennsylvania. Matthew Guido is a project manager in the Healthcare Transformation Institute.
Comments
Post a Comment