Ask any number of health-care experts to name the Tulsa area’s greatest challenge, and physician shortage is at the top of the list more often than not.
Aging baby boomers coupled with a large percentage of older physicians who are nearing retirement complicates the issue. So does the health-care reform’s push to insure more people.
“Physician manpower is a huge issue,” said Mona Wright, executive director of Tulsa County Medical Society. “Some of that is a little bit skewed because a lot of it is in the rural areas, not necessarily in the Tulsa or Oklahoma City area. But we don’t have enough physicians.”
In 2012, Oklahoma ranked 45th for active physicians per 100,000 population, according to data from the Association of American Medical Colleges. The state had 7,552 active physicians, including 5,985 medical doctors and 1,567 osteopathic doctors.
Oklahoma ranked 44th for its number of active primary-care physicians per 100,000, according to the AAMC.
This shortage becomes more concerning when coupled with a rising demand for health services.
Aging baby boomers will need more services, especially in the areas of orthopedic and joint replacements, cardiovascular disease, and prevention of heart attack and stroke, said Dr. Gerard Clancy, president of the University of Oklahoma-Tulsa. Cancer also is a disease of the older population, as well as psychiatric issues.
Add to that the push for trying to get the uninsured insured, and the need for more physicians as well as health-care providers becomes prominent.
“About 41 percent of doctors are 55 and older,” Clancy said. “In the next 10 years we will have a huge group of doctors that will be moving into retirement age.”
In 2012, some 2,237 of the state’s total active physicians, or nearly 30 percent, were 60 or older, according to the AAMC.
To address the shortage, the University of Oklahoma-Tulsa School of Community Medicine and Oklahoma State University Center for Health Sciences are ramping up their medical school classes and residency programs, Clancy said. OU has added a physician assistant program in Tulsa.
“But I worry that it’s such a long pipeline from undergraduate to medical school to residency to fellowship that we won’t be able to graduate any trained physicians by the time this real demand of health care hits hard,” Clancy said.
One way the health-care field is addressing the crunch is by organizing health care around teams rather than expecting the physician to do everything, Clancy said.
Tulsa is one of seven demonstration cities for the Comprehensive Primary Care Initiative a program that organizes health care around a patient-centered medical home where interdisciplinary teams deliver “proactive and coordinated preventive and chronic care” to patients. The initiative includes 67 clinics from Stillwater to Westville and 268 primary care physicians.
With the program, Medicare works with commercial and state health-insurance plans and offers bonus payments to primary- care doctors who better coordinate care for their patients.
OSU Center for Health Sciences is tackling the workforce shortage by targeting high school students in rural and urban pockets where physician shortages exist and developing relationships with them, says Dr. Kayse Shrum, president of the OSU Center for Health Sciences, home to the OSU College of Osteopathic Medicine.
For about the past two years, the medical school has offered a job-shadowing program called “Dr. Pete’s Student of the Day,” where students can follow a physician and explore the possibility of going into the health-care field. The center tries to recruit from under-represented populations.
Many students don’t have a role model or know how to become a doctor, Shrum said, so they often don’t consider it an attainable goal.
The OSU College of Osteopathic Medicine also offers a Med-Xtravaganza program, an open house for high school and college students interested in a medical career. The next program for college students takes place 9 a.m. to 2:30 p.m. March 9 at the OSU Center for Health Sciences, 1111 W. 17th St. Registration deadline is Feb. 28. A program for high school students will be held in fall 2014.
Through the program, students and their parents meet with OSU medical students, faculty and admissions staff. Med-Xtravaganza participants can get information on admissions criteria; engage in hands-on demonstrations; test their suturing skills; study anatomy with a human heart, lungs and brain; and more.
The idea is to expose them to the medical field, Shrum said.
Last year for the first time, OSU introduced Operation Orange and took its medical school and students on the road to visit students in Tahlequah, Ada, Enid and Lawton. More than 150 students attended the daylong camp. More info on this program and Med-Xtravaganza is available at medicine.okstate.edu
OSU Health Sciences Center has also started an early admission program that allows college sophomores to apply for medical school. If accepted, students can start med school as college seniors.
Students still receive their bachelor’s degree but start medical training a year earlier. It will allow more doctors into the workforce sooner, Shrum said.
OSU’s College of Osteopathic Medicine also has increased the number of applicants it can accept from 88 about three years ago to 115 now. It receives about 2,000 applicants each year.