New health care law may impact number of doctors in state

By Elizabeth Crisp/The Clarion-Ledger

JACKSON — Having grown up in the small town of Raleigh, Jeremy Wells remembers the local doctor being a linchpin of the community.

“You would see him everywhere and everyone knew him,” the 24-year-old University of Mississippi Medical Center student said. “He was a very important part of our community.”

That hometown doctor is what Wells aspires to be, and Mississippi might need more people like him once the nation’s new health care law goes into effect.

The legislation may have a dramatic effect on the supply of doctors in Mississippi.

The law mandates coverage for the uninsured by 2014 and encourages preventative care through primary care doctors.

Mississippi already has the nation’s largest shortage of doctors. It also has more than half a million people who could gain health insurance when the law takes effect.

“With more people covered, access is certainly going to be a problem,” said Dr. James Keeton, UMC’s vice chancellor for Health Affairs and dean of the School of Medicine.

As Mississippi’s only medical school, UMC produces at least half of the doctors in the state.

The medical school has been working to increase enrollment, but budget issues have slowed the efforts. The goal is to get each entering class up to 165 students, but Keeton said adding 30 more people won’t be possible without more money.

“I think we’ll be stuck at 135 for at least the next two years,” he said.

UMC needs a new structure to replace the aging School of Medicine building; it needs additional funding for resident and intern positions so that students can get adequate training; and, because of student-teacher ratio requirements, the medical school needs more funding for faculty, Keeton said.

“Catching up is hard and the only way we can is if we get more money,” he said.

According to the Association of American Medical Colleges, Mississippi has 63.8 active primary care physicians for every 100,000 people. The national average is 89.6.

The shortage isn’t just Mississippi’s problem, though.

AAMC predicted in 2008 that, under then-current patterns, the nation would experience a shortage of 124,000 full-time physicians by 2025 because of population growth, aging and other factors. It did not factor in health care reform.

The association has praised the passage of the health care reform legislation, while noting there are challenges ahead.

William Rosenblatt, a first-year med student at UMC, said he’s anticipating the possibility of pay cuts and shifting reimbursements in the primary care field.

“Not everyone’s going to be happy about that,” the 24-year-old Woodville native said.

The argument has been made by some of the health care law’s detractors that people may be less likely to go into medical fields, but Ole Miss Chancellor Dr. Dan Jones, who led UMC from 2003 to last year, dismissed the notion.

“I think regardless of what we do, physicians will always be able to make a comfortable living,” Jones said.

Jones compared doctors to teachers, saying both fields attract people who are drawn to public service. “Money has never been a good reason to choose this career,” he said.

Kelly Shoemake, a second-year med student at UMC, said she was drawn to the field because she loves science and is excited about the patient interaction.

“I’ve always wanted to be able to help people,” the 23-year-old from Mize said.

Wells said he has mixed feelings on the health care law.

Officials say the cost of health care reforms — estimated at $940 billion over the next 10 years — will be paid by levying a new tax on high-end health plans and higher taxes on the wealthy.

“If it can help people, then that’s very important,” he said. “I don’t know about the increased taxes, though.”

Wells said he also has seen first hand how difficult it already can be for some people to schedule doctor’s appointments in a rural area.

“My grandmother is on Medicare, and it can take four months for her to get an appointment,” he said. “It doesn’t matter how many people have insurance if there isn’t a doctor to see them.”

The Legislature created the Mississippi Rural Physicians Scholarship Program in 2007 to encourage more UMC students to become primary care physicians in rural areas.

Students who agree to serve in a primary care specialty in a rural area get $30,000 a year to complete their training.

Wells, who is one of the recipients, said the scholarship will make it easier when students begin to practice medicine. While they won’t make as much money as some specialists, they won’t have the heavy debt load when they’re starting out, he said.

Rosenblatt said he didn’t grow up expecting to be a doctor, but he’s glad he chose the primary care field. He said he was drawn specifically to family medicine and internal medicine because of the variety they provide.

“You literally see mother, grandmother and daughter at the same clinic,” he said. “You could see a baby in the morning and an 80-year-old grandmother in the afternoon.”