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Florida Needs Holistic Approach on Physician Workforce Issues

Fraser Cobbe

Orange County Medical Society

Seminole County Medical Society

The Florida Legislature and hospitals throughout the State should be congratulated for their efforts to expand residency training opportunities. Florida has long trailed other states with large populations in the number of residency training slots available for medical students. The inability to secure adequate financial support from the Federal Government has necessitated institutions and the Florida Legislature to act. A report entitled Training Tomorrow's Doctors: Graduate Medical Education in Florida released by the Teaching Hospital Council of Florida and the Safety Net Hospital Alliance of Florida, details those efforts underway to address our workforce needs and what more needs to be done to make sure Floridians have access to the health care services they need.

In addition to expanding residency opportunities, there are other steps that should be taken to ensure an adequate supply of physicians and specialists are available to treat our growing population.

The crushing amount of debt that medical students carry when they complete their training is often cited as the most critical challenge young physicians face as they enter the work force. Now more than ever, this debt load often dictates where they practice, in what environment they will practice, and whether they will practice in the specialty in which they trained. The need for new physicians to secure a guaranteed and consistent paycheck just to pay off their debt is very real. It is becoming as important a consideration as the lifestyle and professional preferences of pursuing a particular specialty or considering different practice environments. Creative solutions need to be found to make sure that medical student debt does not shape the future availability of health care services in our state.

Florida also has a physician work force that is threatened by burnout and the increasing administrative work load being demanded by insurance carriers. The number one complaint we receive in our office from physicians is the amount of time and resources they have to dedicate to procedural and administrative tasks simply to care for their patients. Insurance carriers have instituted a tsunami of treatment authorization protocols, guidelines, and peer-to-peer consultations that are negatively impacting the healthcare delivery system with questionable added value.

Most physicians can accept participating in utilization protocols and quality improvement activities that are transparent and clearly add value to how they deliver care to their patients. The Legislature needs to look at holding insurance carriers accountable for the efficient utilization of health care resources by demanding that authorization procedures are transparent and effective. If these processes are truly designed to improve care, then physicians should be reimbursed for their time participating in these enhanced care delivery activities.

The efforts underway in Florida on the supply side of the work force equation are to be commended and certainly more investment in residency training needs to take place. We also need to address the legitimate concerns of those physicians already in the workforce to make sure the practice of medicine is sustainable and they can continue to work in the specialties in which they were trained.

Read the full report here.

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