Family Doctor Shortage Will Hurt Rural Areas

The prognosis for primary care doctors doesn't look good.

While primary care doctors are a good fit for communities of fewer than 10,000 people, few doctors want to practice there.

Of the final year medical residents surveyed by Merritt Hawkins & Associates, a physician recruiting firm in Irving, Texas, none said they wanted to practice in a community with 10,000 people or fewer. And less than 1 percent of the residents said they wanted to go to a town with between 10,000 and 25,000 people.

To add to the small town's misery, the number of primary care doctors is shrinking. One reason could be the long hours and the pay rate. At $145,000, family practice doctors have the lowest average starting salary of any medical doctor, according to a 2007 study by Merritt Hawkins.

About a decade ago, the University of Arkansas for Medical Sciences graduated between 40 and 45 students a year who were going to go into family medicine, making it third in the country for the number family medicine graduates, said Chancellor Dr. I. Dodd Wilson.

UAMS is still third in the country for the graduation of family doctors, but now it only graduates about 20 doctors a year.

"The shortage is going to be most acute in the rural [areas]," Wilson said. "And it's going to be a huge problem."

It's already a problem for Pike County.

Pike County Memorial Hospital Administrator Rosemary Fritts has seen how hard it is to get doctors to even look at the hospital in the town of just under 1,700 people.

At the beginning of 2007, the hospital didn't have a doctor.

"We had 3.5 at the end of '06 and two left and one retired," Fritts said.

The doctor who was working part-time, 82-year-old Dr. Hiram Ward, came out of retirement to practice for the first two and a half months of 2007.

The hospital turned to Merritt Hawkins & Associates for help.

Fritts said the hospital spent between $40,000 and $50,000 for a one-year contract for the firm to search for a doctor.

"For a little rural hospital, that was an astronomical amount of money," Fritts said.

For the fiscal year ending Sept. 30, 2006, the hospital reported $2.5 million in patient revenue - the lowest in Arkansas that year - and a net loss of $420,000. For the previous year, the hospital had $2.7 million in revenue, also the lowest amount in Arkansas, and reported a loss of $136,000.

The hospital hired Dr. Lonnie Joseph Parker, who was convicted by a federal jury in 2000 of possession of child pornography, because he was the only doctor willing to move to Murfreesboro.

In court filings, Parker said he had a legal justification to have the images. Parker maintains he was working with government officials to help catch the perpetrator. His medical license was revoked in 2002 but restored in 2005.

Fritts said she investigated Parkers' case and "I will defend him."

But the hospital's board decided to withdraw Parker's contract.

Losing Parker was "a blow to us because if we had gotten that doctor in here at that point in time, he would have been aggressive," Fritts said. "He was knowledgeable, very, very knowledgeable."

Instead of Parker, the hospital found Dr. Richard Plant, 74, who started in April.

"We definitely need one more [doctor] pretty quickly," Fritts said. "We're not actively looking because we don't have the resources."

Recruiting a doctor could cost a couple of hundred thousand dollars, because sometimes the hospital will pay the first or second year's salary for the doctor, said Phillip Miller, a spokesman for Merritt Hawkins.

But each doctor generates on average $1.5 million a year for the hospital.

"It's a good investment," Miller said, "provided you're successful at it."