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Doctor shortage expected here

| August 23, 2007 11:00 PM

By CONSTANCE SEE

Whitefish Pilot

Medical administrators are forecasting a shortage of physicians in the Flathead Valley within the next decade, as a rural doctor shortage that has spread around the globe appears to be coming to Northwestern Montana.

"We're at a crisis level now, but we're heading toward a real disaster in the next five-to-10 years," said Dr. Jay Erickson.

Erickson knows what the future will hold for the Northwest. He is assistant dean for the University of Washington's School of Medicine's rural residency program, which offers scholarships to medical students who commit to practicing in rural communities in Washington, Wyoming, Alaska, Montana and Idaho following graduation.

"I would not disagree with Jay," said North Valley Hospital CEO Craig Aasved. "I think we're close to a disaster here. I don't think the system can keep functioning the way it is for the next five years. Society is used to getting in and seeing a physician when they need one. In the future, it will be tougher with longer lines, longer waits, and we are a society that doesn't want to wait for anything."

Aasved said the first areas to be hit will be the internal medicine and primary-care fields, even as the hospital's patient count keeps growing. The hospital's birthing center continues to see a 20 percent rise over last year.

"How do you attract people to go into healthcare when they're required to work nighttime shifts, carry beepers and be on call, when there are other careers they can go into and make better money?" Aasved asked. "There are other choices today that didn't exist 20-30 years ago."

Dr. Betty Kuffel, a hospitalist at North Valley Hospital, obtained her degree more than a decade ago, following a prior career as a nurse. She said it's far easier to get into medical school today than when she attended.

"There are lots of empty seats now," said Kuffel. "Part of the reason is, it's gotten to be an antagonistic field with so many regulatory authorities and frivolous lawsuits and lawyers."

According to Aasved, there are many elements to the healthcare crisis — rapidly rising malpractice insurance rates that are doubling and tripling, a graying Baby Boomer population with more medical needs, and a rising uninsured and under-insured population.

"The trend I'm seeing is people purchasing these catastrophic health plans, but they come in for a surgical procedure to have a baby with a $10,000-$20,000 deductible and can't afford to have the baby," he said. "The other part is no accountability to the patient. Obesity is at an all-time high and there's no incentive, no reward, no accountability in the system."

Looking forward, Aasved said options for consideration will include creating a less expensive urgent-care track staffed by nurse practitioners and physician assistants, not doctors, and increasing alternative therapies.

"I don't think there's anything bright about the future," said Aasved. "You watch the presidential campaigning and besides the war, the next important item to the average American person is healthcare. The bigger picture is the system is broken, out of control. It cannot keep growing the way it is. The best way to say it is, there's a big train wreck coming unless the whole system is overhauled."

The doctor shortage is not limited to rural communities in the Rocky Mountains. In Massachusetts, new patients have to wait an average of 52 days to see a family doctor or internist.

In British Columbia, a shortage of hospital beds has sent pregnant mothers to the U.S., according to a June article in the Globe and Mail, and the crisis has prompted a sign-on bonus of half a million dollars for a rural physician in the shire of Temora in New South Wales.