Friday, June 23, 2023

Kentucky keeps losing doctors when it needs more of them; in the 2022 fiscal year it had only seven for every eight it had in 2018

Ky. Health News graph from UK Center for Excellence in
Rural Health data; there are no data for Fiscal 2021 due to
the pandemic. (Click on any image to see a larger version.)
Kentucky Health News

Kentucky is losing physicians at a time when it needs many more of them, the top executive of the Kentucky Medical Association told a legislative committee Wednesday.

From 2019 to 2022, the last fiscal year for which data are available, “We lost 590 physicians out of the state . . . at a time that we needed more physicians in the state,” KMA Executive Vice President Patrick Padgett told the Interim Joint Committee on Health Services.

And the loss is even bigger going back to Fiscal 2018, the year that the number of licensed physicians in Kentucky peaked at 11,437. (Fiscal years run from July 1 to June 30.) In Fiscal 2019, the number dropped to 10,592. That was a drop of 7.4 percent. The decrease from 2018 to 2022 was just over 12.5 percent. That's one-eighth, so for every eight doctors in 2018, the state had only seven in 2022.

The decline in primary-care physicians was much less, 3.4 percent: from 2,825 to 2,729. However, 43 of the state's 120 counties are considered short of primary-care doctors, and Kentucky ranks 40th in the nation in the number of primary-care physicians per 100,000 people, according to a report by the University of Kentucky's Center for Excellence in Rural Health. It says 25 counties are considered short of doctors overall, and "Almost a third of Kentucky physicians have been licensed between 31 and 50-plus years," meaning many will retire relatively soon.

Padgett told John McGary of WEKU-FM that having fewer doctors overall "means that people have to wait longer to see a physician. I think that anyone around the state who tries to get in to see a physician, whatever the physician specialty, wherever they're located, when you have to wait weeks, or sometimes months to get in to see a physician, you're experiencing this problem." 

KMA executive Patrick Padgett
Padgett told the committee, “Three years ago, I would have come here to say that Kentucky badly needed more physicians. And unfortunately, the situation has only gotten worse. And we really need to work to not only bring in more physicians but keep the ones that we already have.”

A KMA survey last fall "showed many of the state’s physicians are dealing with increased levels of stress," notes Sarah Ladd of the Kentucky Lantern. "The degree to which that affected their work varied. Most cited administrative burdens such as prior authorization requirements as a driving force behind their stress. During the 2023 legislative session, legislators considered adding exemptions to the state’s prior authorization requirements, but the bipartisan bill was stuck in a committee."

The General Assembly did pass a bill to protect Kentucky doctors who seek mental-health help from wellness programs, by saying doctors don't need to report their participation, Ladd notes: "Their jobs will also be safe if they do so."

Much of the decline in licensed physicians came during the Covid-19 pandemic, when much attention was given to the increasing shortage of nurses. Delanor Manson, CEO of the Kentucky Nurses Association, told the committee that the state needs to improve the health-care workforce pipeline and keep nurses in the profession, Ladd reports.

“Health care is the engine for the economy,” Manson said. “And nurses are the engine for health care.”

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