Healthcare experts would like for us to believe that Florida – and indeed the nation – is on the brink of yet another “crisis,” marked by a significant shortage of doctors that extends into suburban and rural areas. Is it true? The data seems to indicate a growing problem. For example, last year, Jacksonville alone was found to have a deficit of 510 doctors – a number based on how much of the population each physician can serve – and forecasts for the future, helpfully provided by advocacy groups, suggest the problem will get much, much worse if we don’t do something about it now.
Just what is the problem, exactly? It’s longer wait times, extended drives to neighboring towns to see a primary care physician, and even longer trips (and wait times) to see specialists. Higher costs come with the territory, too, and ultimately, worse health care outcomes for everyone.
It turns out that Florida’s rural patients are in the same boat as the state’s urban patients when it comes to getting face time with the right doctor, and for the same reasons: too many patients, not enough doctors. But pick your poison: in rural areas, you might drive long distances to see a doctor, while urban patients just have to sit in more traffic to get across town. Either way, the doctor shortage is making itself felt. And it’s only going to get worse, experts say.
Contributing to the shortfall are three converging factors: a shakeout in the profession following the COVID-19 pandemic, an uptick in retirements combined with a general workforce shortage, and finally, a state population that has ballooned by 21 percent while the influx of doctors and other health care specialists hasn’t kept pace. A report from 2021 anticipated that by 2035, doctors in Florida will meet only about 76 percent of the healthcare demand.
But another factor also plays a key role: the influx of new doctors completing their medical training and entering the profession. While few people are sympathetic to the notion that doctors aren’t making enough money, the fact of the matter is that the healthcare future of Florida and the rest of the nation depends highly on finding ways to convince young men and women with the right aptitude to dedicate many years to the long, expensive and grueling process of becoming doctors in the first place.
Doctor compensation plays an outsized role in that process, so when doctors say they aren’t making enough money, we can easily validate their complaints by checking to see if we have a shortage of people lining up to become doctors. As with any job in a free market system, when there are plenty of people vying for a job, it’s safe to assume the compensation package is lucrative enough to attract ample talent. But when there’s a shortage, one of the key questions we have to ask is: Are we offering the right compensation?
Medicare reimbursement rates are one of the key factors in doctor compensation. Over the past two decades, physicians have seen an effective 26 percent reduction in these rates, according to the American Medical Association (AMA), which represents doctors before Congress and state legislative bodies. The group also says the cost of running a private medical practice has shot up by nearly 50 percent over that same period, causing many doctors to downsize their practices or withdraw from the Medicare system altogether.
In Florida, that hits hard, with more than 22 percent of all residents dependent on Medicare.
Those numbers have also gotten the attention of U.S. Rep. Gus Bilirakis, who has recently said that consistent cuts to Medicare providers jeopardize seniors’ access to quality care. Given that Florida is home to more than 4.8 million Medicare beneficiaries—the second-largest number in the nation—the matter is of considerable importance.
“Continued year over year cuts to Medicare providers jeopardizes seniors’ continued access to quality care,” said Bilirakis. “Further reductions will only serve to accelerate healthcare consolidation – whereby limiting patient choice and access, exacerbating healthcare inequities and a continued rise in overall healthcare costs. We need patient-centered reforms that ensure continued access to quality care for all Americans.”
Right now in Congress, a pair of Florida Republicans, Rep. Neal Dunn (FL-2) and Rep. Bill Posey (FL-18) are pushing to support H.R. 2474, known as the Strengthening Medicare for Patients and Providers Act. The bill proposes to link Medicare physician payments to the Medicare Economic Index (MEI), thereby providing a sustainable solution to an outdated payment model.
It may be tempting to think that doctors are wiping their tears with money. But ignoring the underlying impact – a shortage of doctors – is like ignoring that nagging pain in your stomach only to find out later that it’s a serious ulcer. It is best to treat the problem now, before it becomes more acute.