Misdiagnosis And Cure For Florida Doctor Shortages

There's this joke about the researcher who taught a flea to jump when he said "Jump." He proceeded to remove the flea's legs one by one and ordered it to jump. The flea did so every time till all six legs were removed and then it did not jump. So the researcher concluded that when a flea loses all its legs it goes deaf.

Now relate this to a chain email that I received a couple of days back:

"A recent Physician Census by the Palm Beach County Medical Society confirms that the patient access to care crisis in Florida will worsen as the shortage of physicians reaches dangerous levels. In Florida, like many states across the country, patients can't get the care they need when they need it. Medical lawsuit abuse is forcing good doctors to flee the state, cut back on vital services, or leave medicine altogether. This update to the study shows that the shortage of neurosurgeons is even worse than indicated in the original Physician Census.
Palm Beach County currently has serious shortages of neurosurgeons, general surgeons, and family physicians. The Physician Census confirms that the patient access to care crisis will only get worse and that by 2011:

• Only 70 general surgeons will service an estimated population of over 1.4 million—a number that falls far short of the 208 needed for adequate patient care;
  
• Just 194 general and family physicians—not even close to the 373 needed—will be active in the county;
  
• Only seven neurosurgeons will treat emergency patients while 20 will be needed to meet demand;
  
• Physician shortages of 33% or more will exist among seven essential specialties, including obstetrics and gynecology, thoracic surgery and radiation oncology.

Dr. Jose Arrascue, President of the Palm Beach County Medical Society, cites medical lawsuit abuse as the reason for the bleak outlook for Palm Beach County patients. He says, “too many good doctors view this as a hostile market, with high malpractice premiums [and] no protection from lawsuits.” Most simply decide to practice elsewhere.
With forty-two states now considered to be "in crisis," "verging on crisis," or "experiencing serious problems," Florida patients aren’t alone. And there’s no time to waste. We must work together to fix our nation’s broken medical liability system. Please take a moment to

pass this information along to your friends, family, neighbors and colleagues and ask them to stand with us to protect each and every patient’s access to quality medical care and stop medical lawsuit abuse once and for all.

Thank you for your continued support.

Doctors for Medical Liability Reform317 Massachusetts Ave., N.E.Suite 100Washington, DC 20002
Phone: 1-877-9REFORM dmlr@ProtectPatientsNow.org "

Ironically, this email itself mentions the fact that "Florida is not alone" but "one of the forty two states" that faces doctor shortages. In other words, the root of the problem is a NATIONAL shortage of doctors who therefore have the luxury of picking the place where they want to work. The genesis of this is the artificially constrained pipeline and supply of doctors that I've mentioned in my blog yesterday. Malpractice caps and other tort reforms are certainly necessary but they at most shift the doctor scarcity from one place to another without solving the underlying problem.

Now consider the fact that excellent and highly experienced foreign doctors would swarm into Florida with or without malpractice reforms if only they are allowed to practice here without the bottleneck start-at-the-bottom residency requirement. Fear of importing incompetent or undertrained doctors or those with degrees from dubious institutions? How about allowing in medical graduates only from world class and reputed foreign institutions AND requiring them to pass a rigorous set of Board exams before being licensed?

Such a measure will truly "Protect Patients Now" (the website name of the body behind the email campaign) but expect the physician lobbies to vehemently oppose this. Not surprisingly, they instead push the wrong conclusion, like in the flea joke. Meanwhile, Florida has already enacted some tort reforms. For those still interested at this point here's an article that provides some details in a balanced perspective while questioning the assertions of widespread doctor flight from Florida:

http://www.floridatrend.com/print_article.asp?aID=46144