A nationwide shortage of doctors that’s only expected to grow during the next decade means that for executives at Arkansas hospitals, recruiting physicians to serve their hospitals and clinics is a full-time, 24-7 job.
“We are constantly recruiting and we always have been,” said Richard Turnage, vice chancellor for regional campuses at the University of Arkansas for Medical Sciences in Little Rock. “We are never at full staff. There’s a maximum number you need, but people retire, people move to another state, people decide to go into private practice. You are constantly recruiting.”
The physician shortage could reach as high as 124,000 by the year 2034, according to the Association of American Medical Colleges.
That number includes a projection of primary care physicians coming up between 17,800 and 48,000 short.
Arkansas ranked 46th nationally with 215.4 physicians for every 100,000 people, a report released last year by the association said. The U.S. average was 286.5 for every 100,000 people.
The primary care physician segment was better, with 80.2 for every 100,000 people, the 37th best nationally. The U.S. average was 94.4.
Although it’s a constant challenge for hospitals to recruit physicians to rural areas, finding doctors to serve growing urban areas also takes effort.
In northwest Arkansas, the area’s rapid and continued growth makes it almost impossible to keep up with the medical demands.
There is no way to even accurately determine exactly how many physicians are needed, said Scotty Cooper, a surgeon and regional physician executive for Mercy in Rogers. The best answer is “more.”
“There is a physician shortage nationwide that is projected to get worse,” Cooper said. “We are not immune to that. It’s a moving target because the area keeps growing. That will spur ongoing recruitment indefinitely. It’s hard to say [how many] but, if you look at the projected needs and growth in both areas, it’s stunning how many doctors are projected we need.
“There is no question it is a lot of folks.”
Physician shortages are often felt more keenly in rural communities that don’t have the population to support in-depth medical care, and 41% of Arkansas’ population live in rural areas. A small community might have a family doctor, but often speciality care, surgery and the like are miles away.
“I was talking with a mayor of a small town and he was talking about the importance of having obstetricians in his community,” Turnage said. “It was hard for him to recruit chemical engineers from really good schools if the nearest place that, in this case, a wife could deliver their children was 60 miles away.”
Fourteen of the state’s 75 counties have been designated as a Health Professional Shortage Area (HPSA) for primary care physicians by the U.S. Department of Health & Human Services. Another 41 counties have a HPSA designation for low-income residents.
David Hunton, Mercy’s regional physician executive in Fort Smith, said it took the hospital seven years to find a physician to serve at its 24-bed hospital in Waldron, 45 miles south of Fort Smith.
“I think it is definitely harder to recruit to the rural areas,” Hunton said. “The farther you get away from population centers and the mothership, the harder it is to get people.”
The state has attempted to address some of the shortage issues. Two new osteopathic medical schools — in Fort Smith and Jonesboro — have opened and are sending graduates into the state’s residency programs.
The state’s hospitals have worked to increase their residency slots by 140 since 2016, so that in-state graduates can do in-state residencies. Studies have shown that a majority of doctors take permanent jobs near where they served their residencies.
The AAMC says Arkansas excels at this. For physicians who completed their graduate and postgraduate studies in Arkansas, more than 80% practice in the state, the fourth best in the nation.
Ryan Gehrig, president of Mercy Arkansas, said the state’s hospitals are at a recruiting disadvantage because they receive low reimbursement from Medicare providers.
“Finances are part of it; you can almost liken finances to opening the door,” Turnage said. “There has to be a basic level of money that the market is going to demand. Then other things become really important: the culture of the organization that the person is joining. The work-life balance that they are going to be in is important. The resources they will have at that organization. All those things weigh into this.”
So to compete with more affluent offers from other states, hospitals tout their culture and the availability of high-tech medical equipment. For some, Arkansas’ natural beauty provides a selling point.
“Physician shortages are a growing concern across our entire country including specialties such as general and vascular surgery, neurosurgery and OB/GYN,” said a spokesperson for Northwest Health in Springdale. “Northwest Health recruits nationally year-round and proactively markets the opportunities which we expect may arise in the future. Northwest Health leverages current physicians’ relationships and the rich and diverse geography of Northwest Arkansas to help identify new providers. We feel fortunate to live in such a desirable area as we attempt to recruit and bring physicians into our area.”
Cooper said Mercy has done well in hiring physicians recently, with more than 100 doctors joining the system. Certain specialists, such as rheumatologists and neurosurgeons, are harder to find than others.
“Some of the specialties are particularly hard to find,” Hunton said. “Despite the number of doctors we have hired in the last couple of years, both in northwest Arkansas and Fort Smith, we are still short of primary care physicians by a pretty good number, especially in the River Valley. Recruiting is continuous because there is still not enough.”