Though physician shortages have increasingly become a problem across the country over the last decade, many expect the situation to worsen as millions of newly insured Americans gain coverage under the federal health care law next year.
The shortfall of primary care physicians is expected to grow from an estimated 40,000 today to 65,000 in little more than a decade, according to The Associated Press.
In 2010, there were 258.7 active physicians per 100,000 population in the United States, ranging from a high of 415.5 in Massachusetts to a low of 176.4 in Mississippi, according to the 2011 State Physician Workforce Data Book Center for Workforce Studies — which is provided by the Association of American Medical Colleges (AAMC). States were classified into one of five groups, and Indiana ranked in the second-worst category, with 209-233 active physicians per 100,000 population.
Indiana was 38th in the country, according to the AAMC.
Indiana also landed in the second-worst group for primary care physicians per 100,000 population in 2010, according to the AAMC. That also ranked 38th in the U.S.
Indiana ranked highly, however, in the percentage of medical and osteopathic students who stayed in the same state to practice from which they received their undergraduate medical education, according to the AAMC. Indiana was in the top category, 46.6 percent to 61.9 percent. Nationwide, only 38.6 percent remained in state.
In terms of physicians retained from undergraduate medical education, Indiana ranked sixth-best in the country at just over 50 percent, said the AAMC; state median for the country was just over 39 percent.
John Moore, a professor of Biology at Taylor University who works closely with most of the school’s pre-med students, said that he hasn’t seen any decrease in the number of pre-med students at Taylor. Instead, they’ve had slightly larger-than-normal groups enroll the past couple years.
Moore did say, however, that more are coming in to become physician assistants, because “it’s a shorter route to be able to practice.”
“That track takes less time for schooling and residency, so they can practice sooner,” he said.
In recent years, nurse practitioners have become an answer to the nationwide physician shortage.
According to online medical encyclopedia Medline Plus, nurse practitioners perform many of the same duties as traditional doctors, such as performing physical exams and diagnosing diseases. They are also allowed to write prescriptions for patients in many states including Indiana.
Though some patients might expect a break on their bill because they’re not being treated by their doctor, that usually is not the case.
Susan Nelson, Dean of the School of Nursing at Ivy Tech, said more and more nursing students are going on to get a master’s in nursing, and many of those use the degree to become nurse practitioners.
Proponents of giving an increased role to nurse practitioners argue that they are able to spend more time with patients than a physician typically would.
Calls to Marion General Hospital to discuss their use of nurse practitioners were unreturned, but in October 2012, MGH CEO/President Paul Usher said the hospital had stepped up its use of nurse practitioners in recent years.
He said at that time that the nurse practitioners are used is a variety of settings, from nursing homes to traditional family practices, to handle patient overflow.
“We (use them) to ensure (that) people get into our system,” Usher said at the time. “You have to leverage (physicians’) time.”
Calls to MedExpress — which opened a branch in Marion this year — to discuss physician shortages also went unreturned.
In addition, the Health Resources and Services Administration of the U.S. Department of Health and Human Services has designated certain regions and counties as having a current shortage of physicians, and they’re scored on a 1-25 scale. Higher numbers indicate greater problems with access to primary care.
The score is a government designation that includes population-to-primary care physician ratio, percent of the population with incomes below 100 percent of the poverty level, infant mortality rate or low birth weight rate (whichever scores more highly), and travel time or distance to nearest available source of care (whichever scores more highly), according to HHS. Some facilities, such as prisons, receive designations, as do some health centers because of their funding.
The federal government also tracks population groups who are “underserved,” like Native Americans; shortage areas do not take into account that other providers, such as nurse practitioners or physician’s assistants, might be available to provide care.
As of June 26, Grant County had a score of 13 — right in the middle of the 1-25 range, according to HHS. 14 counties also had scores of 13 or above — including Delaware County (15).
According to the 2013 County Health Rankings, released in March by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Grant County placed 76th among the state’s 92 counties.
Hamilton, Hendricks and Boone counties claimed the top spots, while Fayette, Crawford and Scott counties were among the worst.
According to the study, Grant County’s mortality rates were 70th in the state.
County residents who died before age 75 reportedly accounted for almost 8,800 years of life lost. Only Blackford and Madison counties ranked worse among Grant County’s neighbors. Wells County ranked second in the state and Huntington County was 18.
Grant County ranked worse in morbidity in the study, placing 81st.
Among the 522 Grant County residents over age 18 who participated in a “random digit dial telephone survey,” 17 percent of them reported being in “fair or poor health.”
The study also indicated a lack of primary care physicians in Grant County. There reportedly is one physician for every 2,121 people in the county. The average ratio statewide is one physician per 1,557 people.
The 2013 County Health Rankings listed Grant County 74th in the state for its physical environment. The county reportedly has seven recreational facilities per 100,000 residents, compared with the state average of nine facilities.
Not all statistics from that March 2013 survey placed Grant County low on the list.
Both mammography and diabetic screenings in Grant County were also 6 percent higher than the state averages.
The study indicated that 26 percent of Grant County children under age 18 were living in poverty in 2011, but that number had decreased compared with 2010.