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Severe shortage of doctors threatens New Yorkers

Though it likely won't come as a surprise to the Buffalo residents who for years have been starved for primary care practitioners, yet another study recently was released illustrating that Western New York is experiencing a primary-care shortage rapidly approaching crisis level. It is high time to reverse this trend.

In a recent survey of 99 hospitals by the Healthcare Association of New York State, New York was found to be short a shocking 804 doctors. Of the 36 doctors that Western New York families lack, a staggering 25, or more than 66 percent, are in primary care.

Concerning as it is to be short a few specialists and general surgeons, it's entirely different to be so short of the doctors families will see most of their lives. These are the physicians who know their health history the best. In its study, the association argued that the shortages were likely caused by poor reimbursements by government payers and private insurers, and the overall shaky condition of our state's economy.

All of this should sound an alarm bell. Not only do primary care physicians form the foundation for our entire health care system, we have been reminded time and time again that if we are to reduce costs and New York's comparably bloated spending, we're going to have to rely on the savings of preventive and primary care.

Furthermore, many of our primary care workers are approaching retirement, which will further exacerbate the shortage. Who will replace them?

In recent years, fewer graduates of New York medical schools have chosen to enter primary care practice. Reasons for this disturbing trend include poor reimbursement, high levels of debt and low job satisfaction among primary care mentors with whom residents work during years of training.

Possible solutions include:

*Changing reimbursement rates to recognize the value of the traditional primary care office visit.

*Improving patient access to preventive health education in doctors' offices that would dramatically improve health care while decreasing the time constraints felt by physicians during office visits.

*Giving out grants for primary care practices to improve information technology and offering more meaningful loan forgiveness and/or payback programs to physicians going into primary care.

E*xpanding New York State Area Health Education Center and other community-based initiatives to develop a recruitment pipeline.

State and federal legislators are discussing and in some cases implementing reforms meant to address the problems of rising numbers of uninsured, high costs and below-average outcomes that plague the current system. No plan will succeed without ensuring a strong and vibrant primary care base. Let's take the necessary swift action needed to keep it that way.

Thomas C. Rosenthal is the director of the New York State Area Health Education Center System in Buffalo.

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