Officials: Health plan may worsen doctor shortage 

With some patients already waiting three to six weeks for an appointment with their family doctor, health professions are sounding a warning that expanded health coverage for the Peninsula’s uninsured could exacerbate an already serious doctor shortage.

The warning comes as a special county task force investigates how to cover all 36,000 to 44,000 low-income, uninsured adults in the county. The idea behind providing coverage for the uninsured is that spending up front on preventative care will save on more expensive and invasive procedures in the long run, according to health experts. Paying for the uninsured would cost about $75 million more, money the county has so far been unable to come up with.

"It’s already tough for patients to get in and see their [primary care] physicians," said President of the San Mateo County Medical Association Dr. David Goldschmidt.

When patients can’t get in to see their family doctor they often turn to emergency room doctors for care, said Goldschmidt, an emergency room doctor at Seton Medical Center.

Two major factors driving the shortage are the county’s high cost of living, among the highest in the nation, and low state reimbursement for programs such as Medi-Cal that cut into doctors’ take-home pay, Goldschmidt said. "It’s all about economics."

With little economic incentive to become a family doctor, more physicians are choosing specialties with higher salaries, such as cardiology or gynecology and obstetrics, said Penny Stroud of Cattaneo & Stroud, a hospital consulting group.

Even without bringing the uninsured on board, the county could find itself short as many as 120 primary care physicians within five years, according to Bob Merwin, CEO of Peninsula Medical Center in Burlingame.

Add an additional 44,000 patients and that could create a shortfall of as many as 170 doctors, according to experts.

The county’s primary care doctor shortage was between 86 and 100, according to a 2004 study by Cattaneo & Stroud. Most health experts believe that figure is growing as the county’s population ages and more doctors are needed, Stroud said.

The over-60 population in the county is projected to increase by 53 percent, to 191,000, from 2005 to 2020, according to data from the state Department of Aging.

Finding solutions to the doctor shortage is among the reasons the county Blue Ribbon Task Force on Adult Health Care Coverage Expansion has asked for an extension of its duties from the original July 1 termination date until the end of the year, according to S.T. Mayer, policy and program analyst for the county.

ecarpenter@examiner.com


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