A recent letter to the editor noted just how hard it is to find a doctor, both locally and at the Roseburg Veterans Affairs Medical Center. The problem of a medical workforce is a problem many years in the making and is just now getting the attention it deserves.
Locally, we have recognized the workforce problem for many years and have taken a coordinated approach to addressing our workforce issues. Mercy, Architrave and DCIPA have a coordinated recruiting approach and have been tremendously successful, so that we have recruited 10 new primary care doctors and five new specialists to Douglas County. We have recruited many new physician assistants and nurse practitioners to increase access. In addition, Mercy, Architrave and DCIPA are actively pursuing the possibility of a family practice training program here in Roseburg.
It is important to understand how we got into this situation. In the late ’80s and early ’90s it was felt that we had TOO MANY doctors. It was predicted that the need for doctors would decrease as modern medicine increased life spans and allowed treatment of previously untreatable conditions. To prevent the expansion of the medical workforce, the size of medical school classes stayed stagnant and the number of training programs grew at a very slow rate.
The prediction of too many doctors proved terribly wrong. Modern medicine has indeed increased life spans, but requires a much larger medical workforce. In my 34 years as a doctor, we have made incredible advances. When I started medical school, the diagnosis of leukemia in kids was a death sentence. Kids with leukemia were kept comfortable and given an occasional transfusion, but almost all died. It did not take many doctors to treat leukemia. Today, about 90 percent of kids survive the common form of leukemia, but it takes a team of pediatricians, pediatric hospitalists and oncologist to make it happen. When I started medical school, tiny babies less than 2 pounds rarely survived the night. Now most live, but only after weeks or months in the neonatal intensive-care unit tended to by dozens of doctors and nurses. Thus, health care is so much better, but it takes many more doctors to do so.
In the last 10 years, we have begun to recognize the workforce shortage, both locally and nationally. New medical schools have been built and many have increased class size, but this has been a very slow process, because it took time to build this capacity. It takes a minimum of four years to get through medical school and then another three to five years to complete a residency. Thus, it takes a minimum of seven years to “mint” a new doctor.
During this shortage time, Roseburg and other communities have used doctors who have trained overseas. While these doctors have been a tremendous asset, this is not a good long-term solution, as it takes needed doctors from other countries and is restricted by a limited number of visas for foreign-trained physicians.
Perhaps the greatest obstacle today is a shortage of training positions for doctors who have already graduated from medical school. About 500 newly graduated doctors could not find a training position last year and this year will likely be worse.
Physician access is indeed a problem long in the making, but I think we were among the first to have recognized the problem and are making every effort to ensure access to medical care for our friends and neighbors in Douglas County. You can help by welcoming our new doctors and supporting the local delivery system.
Dr. Bob Dannenhoffer is a Roseburg pediatrician and chief executive officer of the Architrave Family of Companies. He can be reached at firstname.lastname@example.org or 541-464-4300.