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Shortage of doctors in state worst here ; 91% of hospital ERs lacking specialists

A shortage of physicians is worsening in many parts of the state, including Western New York, according to a survey of hospitals.

The problem was most acute in Western New York, where 91 percent of the survey respondents reported their emergency rooms where not covered by certain specialties at times and 82 percent said they had reduced services because of problems finding some specialists.

The report also said the average age of practicing physicians in the state is 52, and 15 percent are over age 65, suggesting that the pace of retirements will accelerate in coming years, exacerbating the shortage.

Nearly 1,600 physicians retired or left their communities in 2009, a greater number than was reported in 2008, the association said. In a separate release, the association said 130 physicians retired in Western New York in 2009, and 287 doctors were expected to retire in 2010.

"Virtually every community has been impacted by these shortages, and this study suggests this impact will become more pronounced in coming years unless we make our state and our health care facilities more attractive to qualified physicians," Daniel Sisto, president of the association, said.

In Western New York, the problem is less about established doctors leaving than about the challenge of recruiting needed specialists or keeping those who are trained here, said Dr. Mark Lema, president-elect of the Medical Society of the County of Erie.

"The physicians we have are aging along with their patients," said Lema, chairman of anesthesiology at Roswell Park Cancer Institute and the University at Buffalo School of Medicine.

However, based on conversations with colleagues, Lema said more doctors than usual seem to be considering a move out of Western New York because of its reputation for high taxes, lower salaries and heavy state regulations, as well as a desire to live in more popular areas of the country.

"This is a very comfortable place to live, but there are destination states that are more physician-friendly," he said.

Of the association's 220 member institutions, 111 hospitals, including 11 of about 30 in Western New York, responded to the survey.

Statewide, 33 percent of hospitals surveyed by the Healthcare Association of New York State, an advocacy group, indicated they reduced or eliminated services in 2009 because of a shortage of physicians, compared with 24 percent in 2008.

In addition, 69 percent of hospitals indicated there were times when a physician shortage left their emergency department without coverage for certain specialties, requiring patients to transfer to other hospitals for treatment, an increase from the previous year.

The group has produced the survey annually for the last four years as part of its effort to push for changes in legislation and regulations.

It is seeking additional funding and less-stringent requirements for Doctors Across New York, a program that offers loan forgiveness and practice support to physicians who provide care in underserved communities.

It also wants more Medicare-funded medical residency slots to train specialists in New York State, as well as changes to help expand the use of telemedicine.

The survey findings are not significantly different from previous versions or the work of others.

The survey and accompanying report rely heavily on statistics from the Albany-based Center for Health Work Force Studies, whose studies indicate that the demand for physicians in New York is likely to outpace the supply over the next few decades, with the worst problems forecast for New York City and the Hudson Valley.

The Albany researchers last year concluded that it was difficult to gauge what will happen in Western New York because of a handful of forces that could increase or decrease demand for physicians, including population, health reform and economic strength.

The center projects the largest gaps statewide will be in a handful of specialties, including psychiatry and surgery.