Physician shortage seen in area counties

The beginning of a new year also will be the beginning of new Affordable Care Act mandates, designed to increase the number of Americans who have access to health insurance.

This influx of newly insured patients has the possibility to overload the system, especially in areas that have a shortage of primary-care physicians. The U.S. Department of Health and Human Services has assigned scores between 1 and 25 to each county, with the highest scores indicating limited access to care and a possible shortage.

Cape Girardeau and Perry counties fell about midrange with scores of 14 and 12 respectively. Bollinger County ranked slightly higher with a 17, followed by Scott County with 18. The counties that indicated the most potential for a shortage were Alexander County in Illinois, 19, and Stoddard County, 20.

Steven Bjelich, president and chief executive officer at Saint Francis Medical Center, via email said local physicians have been preparing for this influx for years but more primary-care physicians still are needed, and already there aren't enough.

"Recruitment and retention of physicians is more important than ever," he said. "Growing demand for physician services, especially primary care, will make today's existing physician shortage more acute."

He said Saint Francis has been working to combat the problem by partnering with existing primary-care practices and acquiring rural health clinics to increase access to nurses and physicians.

"[Reliable care is important] especially in Southeast Missouri, where according to the county health rankings released in April 2013 by the Robert Wood Johnson Foundation, 10 of the 15 unhealthiest counties are located," Bjelich said. "These populations are a challenge to physicians and nurse practitioners, alike."

Elsewhere in Southeast Missouri, impoverished counties such as Mississippi, Pemiscot and Wayne all have scores of 20 or higher, which are some of the highest numbers in the state.

One possible solution that could minimize the effects of the shortage is using nurse practitioners, though the idea has its opponents. B.J. Whiffen has been a nurse practitioner for 17 years and also is a full-time professor at Southeast Hospital College of Nursing and Health Science. She said in Missouri, nurse practitioners face restrictions that prevent them from "helping to their full potential."

"In Missouri, a nurse practitioner must work within 50 miles of the collaborating physician," she said. "So if your next-closest physician is in Cape, then you can't reach a lot of people in those more rural areas who are really the ones that need care the most."

Whiffen said she is hopeful this restriction will be re-evaluated in 2014 and believes nurse practitioners represent a viable solution to the problem.

"We know we're not doctors. We know we're nurse practitioners, but we're not doing heart surgery or brain surgery," she said. "We're seeing the patients with high blood pressure that can't get to a doctor. We're seeing patients that need help managing their diabetes. We're seeing the kids with runny noses. We're here, and we're ready and willing to help."

srinehart@semissourian.com

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