A reporting breakdown from a Health Lab freelancer
In January, I received a call from my doctor’s office. My usual physician had left the practice, leaving me with two options: I could see a doctor who was filling in temporarily, or delay my physical until there was a new full-time physician available. But, the scheduler warned me, there was no saying when that might be.
I opted to see the temporary doc. Luckily, I have no ongoing health concerns, so it was simple to change my care, even more so because the temporary doctor was personable and patient. I found myself wishing she would set up practice in the area.
Then, at summer camp pickup a few weeks ago, another parent mentioned that our pediatrician was leaving the local practice. As a mom of two adventurous kids, that was worrisome. I knew and trusted this doctor for everything from broken arms to bug bites, and my girls did too.
As I wondered whether my kids would have a pediatrician to see for their back-to-school checkups, my editor here asked me to report on the aging physician workforce in New Hampshire and what it means for the state.
Whether you’re dealing with a chronic health concern, making sure your kids are growing on track, or — like me — only getting to the doctor because it’s part of being a responsible adult, access to health care is important for all Granite Staters. The fact that more than 40 percent of our state’s primary care physicians are approaching retirement age could impact how long we need to wait for doctor’s appointments.
My first task was to put the problem in context. I used national data to learn that while 34.2 percent of practicing Granite State doctors are 60 or older, we’re not too far over the national average of 32.9 percent. Given that our state, overall, has one of the oldest populations in the nation, that made
me feel a bit better about the problem.
Yet as I talked to experts, they explained that New Hampshire, and the Monadnock Region in particular, might have an especially hard time attracting younger doctors because of our rural setting. For many of us who live here, rural life is a major plus, so it’s hard to imagine that it could drive doctors away. Yet younger doctors, like younger people in general, tend to choose more urban settings. I also learned that many doctors practice where they did their residency — often in major cities with teaching hospitals like Boston, New York or Houston.
With that info, I had a new idea of the crux of this story: We (like most states) need more younger doctors. But we also were having a harder than average time recruiting them because of our rural setting.
In a stroke of reporting luck, a news release landed in my inbox about a UNH program that gives existing nurses the education to become nurse practitioners, prescribers who can act as primary care providers. I was intrigued. My kids’ pediatrician isn’t actually a doctor, but a nurse practitioner, and I had alway loved the care he provided. Could highly trained nurses be the solution?
Part of it, according to the folks I spoke to at UNH. The major advantage of the program, ANEW, is that it trains people who are already working in the community. These locals know and love the area, so the burden of selling people on the benefits of rural life is removed. Win-win.
A source then mentioned a visa-waiver program that allows immigrant doctors to remain in the U.S. if they commit to practicing in rural areas for three years. My husband immigrated here after we married, so I knew how much of an incentive a waiver could be, but I also questioned whether these doctors would stay. I was surprised to learn that Cheshire Medical Center in Keene has hired 17 doctors under that program in the past six years, and 16 of them still practice in the Elm City. These doctors tend to be more diverse than the state’s physician workforce overall, which is really important in a state where more than 75 percent of providers are white.
Finally, I remembered reporting I did last year on the new medical residency at Cheshire Medical Center. At the time, I thought it was really interesting to have a residency in a small rural community, and I was a bit jealous this wasn’t an option in my town. Now, I understand just how critical this could be, since a majority of doctors practice in the state where they complete this on-the-job training.
New Hampshire will continue to need to be innovative when it comes to attracting younger doctors to the state. One program from neighboring Maine provides scholarships to local people going to med school, with the same premise as UNH’s ANEW program: when you invest in people already in the community, they’re more likely to stay.
As a journalist, it’s always exciting to report on issues that have solutions. I left this story feeling like important work is being done on this issue.
Now, if I can just figure out what pediatrician my kids will be seeing this fall …
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