Editor’s note: This op-ed is by Margaret Newton, MD, a retired physician who lives in West Brattleboro.
Are doctors leaving Vermont because of Vermont’s plans to develop single payer insurance?
Jeff Wennberg, of Vermonters for so-called Health Care “Freedom,” would have us believe this. His March 22 opinion piece in VTDigger.org implied that some doctors are thinking of leaving Vermont because of single payer.
Doctors leave for many reasons. Of course all have concerns, and change is scary. They know the present system is unsustainable. But most are excited that single payer means universal coverage for all Vermonters.
Vermont has the nation’s sixth highest number (270) of active patient care doctors per 100,000 residents. Only Massachusetts, Maryland, New York, Connecticut and Maine top Vermont. The state median is 215, and Mississippi has the least (160). Vermont tops all states with the most active number of primary care doctors: 112 per 100,000 residents. (See Association of American Medical Colleges’ 2011 annual report at www.aamc.org.)
All states have a physician shortage, especially in primary care and some other specialties. I waited a year for a knee replacement. Without insurance, I’d still be waiting. (That must be what Wennberg calls “health care freedom.”) Tunnel vision blinds him to the national situation. He seems unconcerned that many go without care, and offers no solutions.
America’s doctor shortage won’t be solved easily in Vermont or Washington. We need consensus in identifying the needs and in providing incentives to help doctors locate in scarcity areas. Influential lobbyists, stakeholders, academic medicine, and politicians often can’t agree, and funding is always an issue. U.S. medical schools do not produce enough doctors to meet America’s need today or in the near future. (Several new schools are emerging, and more osteopaths are entering primary care.)
America grants visas to immigrant doctors to train and practice here. Today one in four U.S. practitioners are foreign-born; many are citizens of doctor-starved countries like Pakistan (80) and India (60). They are desperately needed at home.
