Daily Press (Sunday)

Three critical actions needed to address physician shortage

- By Bruce Holbrook and Armistead Williams Guest columnists Bruce Holbrook of Norfolk is president of Bruce Holbrook Consulting, Inc. Armistead Williams, M.D., is a neurologis­t and a former board member of Sentara Hospitals Norfolk and of Sentara Health Sys

“How are we going to replace our group’s physicians when they retire in the next few years?” That is what we are hearing from medical practices all over Hampton Roads. Primary care doctors here are stretched thin caring for their patients as they themselves approach retirement age. This comes on top of an existing regional shortage of primary and specialist doctors, coupled with an aging and not-so-healthy populace.

If you doubt this, listen to friends newly arrived in Hampton Roads who had to wait months to find a new primary doctor, even longer now that Portsmouth Naval Hospital, at the direction of Congress, has drasticall­y reduced clinic availabili­ty for military dependents. Try to find any women’s health/OB-Gyn practice in the city of Portsmouth.

Ask yourself when you’re sitting in the emergency department waiting room for that long (and expensive) visit whether you would be there if your own doctor weren’t too overwhelme­d to work you in that day. The shortage also affects people referred to specialist­s. So it’s shocking but not surprising that a friend with newly diagnosed melanoma skin cancer was told they would have to wait an agonizing six weeks to have it removed.

Dr. Jordan Asher’s Dec. 16 opinion column (“Sentara working to solve the physician shortage in Virginia”) outlined Sentara Health System’s preliminar­y steps to address the issue and promised $4 million distribute­d across Virginia for new training positions. Solving the physician shortage in Hampton Roads will take concerted effort, money and leadership, not only by Sentara, but also by state and local government­s, the Navy and our business community.

Some critical actions needed to solve this crisis:

First, a comprehens­ive study by the joint Old Dominion University-Norfolk State University-Eastern Virginia Medical School School of Public Health to determine current physician shortages as well as the number of doctors — whether at EVMS, in private practice, employed by Sentara or in Navy medicine — who are no longer accepting new patients or who are likely to retire in the next five years. Note that hundreds of EVMS graduates and post-graduate physician trainees work in Hampton Roads. How can we better compensate EVMS and its affiliated fulltime and community physicians to graduate and train new doctors?

Second, inducement­s for doctors to come here and to stay here. According to Virginia Business magazine, Roanoke and Richmond and Charlottes­ville actively compete for physician talent using generous scholarshi­ps in return for a commitment to serve in the community after finishing training. To compete, we need to match these incentives. Asher laid out Sentara’s $4 million statewide program to address this, but total costs to train one physician are almost $100,000 for each year of a four-year training program. So the promised $4 million may entice 10 newly minted doctors to stay somewhere in Virginia, but we need them and many more like them right here in Hampton Roads.

Third, a correction in Medicare fees which are lower in eastern Virginia than in other parts of the country, causing us to lose doctors, including newly trained and excellent EVMS physicians, to cities where salaries are higher. To compete, we need our senators and congressio­nal representa­tives to ask for more competitiv­e Medicare and Tricare physician reimbursem­ents.

Our cities face a critical doctor shortage. We need a comprehens­ive assessment of that shortage. We need the leadership of our mayors, legislativ­e representa­tives and business community working with the team of EVMS President Dr. Alfred Abuhamad, ODU President Brian Hemphill, Ph.D., and Asher, executive vice president of Sentara, if our citizens are to get the medical care they deserve. And we need funds to make this happen.

Published reports show that during just the first six months of 2023, Sentara Health System’s “excess of revenue over expenses” (a non-profit’s profit margin) totaled $637 million. Sentara was already holding on to more than $6 billion in investment­s, the majority of which have been generated in Hampton Roads. In 2023 Sentara spent $225 million to purchase an insurance company in South Florida. In 2024 Sentara should make a similar $225 million investment, this time back here to ensure that people living in Hampton Roads have the physicians and the good health that all of us need.

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