What is causing the doctor shortage? Here's why it's only going to get worse

There's a number of reasons causing the issue.

“It’s kind of tough waiting around when you’re trying to find a good doctor. And in the long run, it’s something you probably could have stayed at home and just found out yourself," said Marian Whitney of North Haven.

You or someone you know may be experiencing seemingly longer than normal wait times to see your doctors - and you're not alone.

“It’s been really awful trying to get appointments with new doctors, some three to six months wait to get in," said Jean Egri of Wolcott.

“Being a man of a certain age in my 60s, you know, I found I needed to see a dermatologist, I needed to see a urologist, an ophthalmologist, you know, a lot of '-gists,'" said Ira Morrison of Bristol.

Morrison said he was told that it would take several months to get in to see a specialist.

“And it took me, you know, six months to get an appointment with a dermatologist, it took three months to get an appointment with the neurologist," Morrison said.

And while waiting periods for patients may already seem long, Connecticut Medical Society President Dr. David Hass said they are only going to get worse.

The pandemic and early retirement

Whether it be primary care or specialty appointments such as neurology or psychiatry, it's a phenomenon that health officials say is only going to get worse.

There's a number of reasons causing the issue. One big factor is that more than one-third of physicians in Connecticut are over the age of 55 and on the verge of retirement, according to the Association of American Medical Colleges (AAMC).

Department of Public Health Commissioner Manisha Juthani says more doctors are retiring early.

“But now you have retirement where people are just saying they’ve had enough, and they’re just exhausted from these last several years. That is just exacerbating the impact," Juthani said.

Physicians told NBC Connecticut Investigates that they're feeling extreme burnout as a result of the pandemic.

"COVID has certainly, unfortunately expedited retirement and there’s been a tremendous number of physicians and nurses and healthcare providers that have chosen to retire early solely because of the fact that they were working their tails off during COVID," Hass said.

The pandemic definitely made bad things worse. The results that we maybe would have seen in 10 years, now we saw in three years.

Dr. Khuram Ghumman, Family Clerkship Director at the Frank H. Netter School of Medicine, Quinnipiac University

The commissioner said people are seeing medical problems that are very complex because they haven't really dealt with issues for years due to the pandemic.

"The interactions between patients and everybody in the healthcare sector, not just physicians, was pretty tense and that wears on people over time, resulting in burnout," Juthani said.

Keeping doctors in Connecticut

Experts say a large percentage of doctors train here in the state and then leave. Data from the AAMC shows that Connecticut ranks as one of the lowest in the nation for retaining doctors.

A program in Oklahoma pays medical students $15,000 a year for up to four years and in Kentucky, primary care physicians who make a two-year commitment to practice in an underserved community get $80,000, according to the National Library of Medicine. Connecticut officials and legislators are considering incentives such as these to keep doctors in the state.

In the meantime, health officials say the state needs to understand how to better incentivize people to practice medicine here in Connecticut - like they're doing in other states.

“There’s so much talent that we train in our state. We’ve got to keep some of those doctors here so that they can take care of people like yourself and your neighbors," Hass said.

Doctors say they are also bogged down by administrative burdens such as insurance paperwork and prior authorizations.

“We’ll be able to see more patients, take care of more people more quickly, and try to prevent disease," Hass said.

Connecticut has three medical schools: Yale School of Medicine, UConn Health and the Frank H. Netter MD School of Medicine at Quinnipiac University. The medical school at Quinnipiac University aims to get students into specialties that need more doctors.

"We want them [students] to do and pick the direction for their career, whichever direction that's more priority to them. We want to nurture that interest while maintaining the desire to keep them in Connecticut as much as possible," Dr. Khuram Ghumman, family clerkship director at the Frank H. Netter School of Medicine, said.

"At some level, we may always be an exporter of trained physicians because of the fact that we may have more training slots than actual full need of physicians," Commissioner Juthani said.

Some specialties really need help

While many primary care physicians in the state are retiring early, there is a large need for specialists, too.

"It's getting more complex to find a specialist if you need a neurologist or cardiologist, a lung doctor..." said Sen. Saud Anwar (D - 3rd District).

A large percentage of doctors in the following specialties are over the age of 60, according to the AAMC:

  • Allergy and Immunology - 52.7%
  • Anatomic/Clinical Pathology - 58.0%
  • Ophthalmology - 50.2%
  • Orthopedic Surgery - 57.0%
  • Psychiatry - 52.8%
  • Pulmonary Disease - 81.1%

Task force aims to solve the problem

The Department of Public Health has a task force made up of physicians and other providers taking a deep dive into the physician shortage and what could be coming.

The task force is looking at ways to retain doctors. Some ideas that officials have include repaying loans, adjusting Medicare reimbursement rates, ease of practice and compact licensing.

“In some cases, that cab driver that is bringing the patients gets paid more than the physician providing the care. And it’s not sustainable," said Anwar.

The group has been meeting regularly to generate a report for the legislature to look at in the next session, according to Juthani.

"I have really learned a lot by listening to the group of people who are facing these challenges every day and thinking about this every day," she said.

Doctors we spoke to say they want to adjust low reimbursement rates for Medicaid and private insurance providers. Anwar says these payments are not enough, and he believes Connecticut should weigh reimbursement options.

"Unfortunately it's leading to many physicians not being able to see Medicaid patients, some of whom are the most deserving and needy patients in our state," Hass said.

The state recently enacted a VISA program to recruit doctors and prioritize specialties like neurology, dermatology and OBGYNs.

There are specific pockets of areas in the state where people are having difficulty getting appointments, according to Juthani. They're called Health Professional Shortage Areas, or HPSAs.

The DPH allows for sponsorship of 30 physicians every year to work in these HPSAs.

What can you do?

There are currently two proposed bills in the state legislature that aim to address the doctor shortage: Senate Bill 9 and Senate Bill 1228.

Senate Bill 9 looks at how to get more physicians trained and how to incentive doctors to make Connecticut home, according to Anwar.

The bill aims "to equalize access to physical, mental and behavioral healthcare in the state..."

Senate Bill 1228 aims to address the healthcare workforce shortage.

"We are trying to see if a physician who's licensed in another state, we will be able to invite them to Connecticut and make it easier for them to be able to practice over here to take care of our citizens in our state," Anwar said.

Anwar said legislators are actively looking into the shortage issue and will work with the Department of Public Health and the governor's team to address it.

Healthcare professionals say it never hurts to express your concerns with legislators.

"Patients far and away, they have a voice and they can talk to their local legislators and explain to them why it's important for their physicians to be available to them," Hass said.

Advice moving forward

The Department of Public Health commissioner says taking a preventative approach to care is crucial.

"Prevention is so much more important than treating conditions when they are already far gone. And the only way to do that is to get plugged into care to begin with," Juthani said.

Professionals say you should also trust in your healthcare team - whether it be a physician assistant, nurse practitioner or someone else - they're all there to care for you.

"I know that patients sometimes will say that they prefer to see a physician, but I think if they can recognize that the team approach to medicine can sometimes be even more beneficial," Hass said.

"If you have insurance, I think making that connection with a primary care provider and at least getting in to see them once, because then you can make a phone call, you might be able to do telehealth, you might be able to do any number of things," Juthani said.

Experts say care is worth the wait.

“Even if it’s like six months away, take that appointment. So before you actually need that urgent appointment, you have this relationship in the making," said Ghumman.

Doctors said this needs to be fixed urgently.

“Yesterday is when change should have occurred and we’re hopeful that there is no more time that’s wasted to allow this problem to get worse," Hass said.

“This is a challenge, and we hear you, we are going to look into this and work with the Department of Public Health, with the governor’s team and the legislators, we have our complete attention on this issue, we have to address this," Anwar said.

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