Rural doctor shortage called "a crisis" in Washington

Rural areas in Washington and elsewhere are facing a shortage of physicians — and the problem is getting worse.

"It's a crisis, there's no question about it," said Anita Monoian, chairwoman of the National Association of Community Health Centers.

Monoian was a panelist Friday at a workshop on medically underserved communities at the 10th annual Association of Health Care Journalists conference in Seattle.

About 400 journalists from around the world are attending the conference, which continues through Sunday at Seattle's Grand Hyatt Hotel. Other workshops dealt with issues such as autism, mental health and aging.

Len Bruzzese, the group's executive director, said health-care reform was the event's overriding issue, given the Obama administration's early push to consider a public-insurance alternative to private plans.

The workshop on underserved communities also featured Mark Doescher, director of the Office of Rural Health Care at the University of Washington's School of Public Health. Rural areas, he said, account for 20 percent of the U.S. population but have only 10 percent of the physicians, and hiring is increasingly difficult.

One recent survey, he said, showed 40 percent of job openings remained open seven months or more.

That concern was echoed by Monoian, who helps oversee about 1,200 community health centers serving 18 million mostly poor patients in rural areas nationwide. Medical-school graduates, she said, have had the upper hand in a game of supply and demand.

"In the '90s, I would wait two or three months to fill an opening," she said. "Now it's 18 months. And let me tell you — I no longer interview physicians. They interview me."

Physicians seeking work are drawn to urban areas for a variety of reasons, including access to thriving specialty-care networks, Monoian said.

Even as the population of older people and ethnic minorities continues to grow in those communities, the shortage is worsening as many current rural doctors reach retirement age and fewer available candidates emerge from U.S. medical schools.

As a result, health clinics and centers are turning more and more to foreign candidates doing their medical residencies in such areas. That can present an ethical challenge because many of those candidates are here via taxpayer-funded programs in their home countries.

"These providers are the cream of the crop of their nation," Monoian said. "They come here with the assumption they will go back."

Retiring urban physicians looking for ways to supplement diminished retirement funds, Monoian said, are another temporary salve.

"It won't stem the tide for long," she said, "but it helps a little bit."

Marc Ramirez: 206-464-8102 or mramirez@seattletimes.com