The Critical Need for Medical Doctors in the State of Louisiana

The American Medical Association (AMA) and the Association of American Medical Colleges (AAMC), among others, have published reports on the impending shortage of physicians in the United States. The retirement of physicians and the aging baby boomer population, alone, will create a need for more trained doctors. According to the reports, existing U.S. medical schools are not presently educating enough students to maintain an adequate number of U.S. health care providers in the near future. Experts are projecting that, by the year 2020, there will be an 80,000 to 200,000 physician shortage nationwide.

The State of Louisiana already experiences the effects of an inadequate number of doctors. Problems that existed prior to Hurricane Katrina were only exacerbated by the storm. To date, no one has been able to even completely quantify how much worse the situation has become. In addition, Louisiana’s citizens will continue to suffer because there are no incentives to retain medical doctors in this state – they move to other states for higher pay and a higher style of living. FICA believes that the emphasis of our community should be to encourage physicians to stay in the state through incentives offered by hospitals.

In conjunction with a group of community leaders, Flood International Consulting Agency (FICA) seeks to pursue measures to rectify this shortage problem. We find it interesting that, over the last twenty years, many entrepreneurs have entertained the thought of building a new medical school in Louisiana; however, none have ever advanced beyond the idea stage. Establishing a medical school in Baton Rouge is a logical pursuit given that the populations of Baton Rouge and its surrounding communities have doubled since Hurricane Katrina. A new medical school would increase the opportunities for students in Louisiana universities desiring to become physicians and help to improve health care in the state. In addition, a new medical school would not only assist in filling the physician shortage gap, but it could also help drive the economy and advance Louisiana’s medical industry. If a medical school were built, in ten years from its opening, Louisiana could expect an additional 25,000 jobs, $6.4 billion in economic activity and almost $2.3 billion paid in wages. These projections are from recent studies on developing medical schools in Florida.

It is time that the Louisiana medical community comes together to fill the void that our state is facing. According to a recent USA Today article, “The predictions of a doctor shortage represent an abrupt about-face for the medical profession. For the past quarter-century, the American Medical Association and other industry groups have predicted a glut of doctors and worked to limit the number of new physicians. In 1994, the Journal of the American Medical Association predicted a surplus of 165,000 doctors by 2000.” But, "It didn't happen," according to David Blumenthal, a Harvard University medical professor and author of a New England Journal of Medicine article concerning the doctor supply. (See the full text article on USAToday).

As for our team, we will do our part by connecting with leaders who can assist us in a variety of ways to advance our local and state communities. The goal is to bring brilliant scientists from various parts of the nation and the world to advance the medical community in the state of Louisiana. We are a unique consulting firm in that our advisors and projects are globally situated, however, our ultimate focus is on bringing progress to the State of Louisiana. For this reason, we have chosen to keep our offices in Louisiana rather than in business centers such as Chicago and New York: Baton Rouge is home and we want to remain a part of its fabric.

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Healthcare in America: Where do you fit in the equation?

It is estimated that 47 million Americans have no health insurance. Economic recession is the mantra repeated from the media as the U.S. economy weakens. Many Americans cannot afford milk or gasoline much less health care. On Capitol Hill, Congress is looking to reduce Medicare payments to physicians by 10.6%, scheduled to take effect on July 1, 2008. The cuts will force Family Practitioners to turn away the elderly just to keep their doors open. The aforementioned problem is a symptom of a system that is worsening. Medicare cuts are at the tip of the iceberg of the larger demographical problem. While senior citizens are living longer, baby boomer physicians are retiring sooner looking for a better life. The American Medical Association (AMA) foresees a 93,000 to 200,000 physician shortage by the year 2020. The Association of American Medical Colleges (AAMC) is calling for a 30% increase in U.S. medical schools. Several states have taken on the rigorous task of building new medical schools while measurably boosting their states’ economic well being.

“The new president of the Association of American Medical Colleges has called on medical schools to elevate the public good above their own self-interest by considering tuition caps, curtailing pork-barrel spending requests, and pursuing socially beneficial research projects even if they are not profitable.”

The focus of U.S. medical schools should be towards addressing the community in the states that they serve. However, this is a national problem and should be resolved at all levels of government. As you read this, ask yourself , when is it enough for lawmakers to sound the alarm for action? To add insult to injury, students are not given good incentives to practice medicine in underserved areas, such as my home state of Louisiana.

The national average of graduating medical students' debt increased 6.9% in 2007 from the previous year to $139,517. 75.5% of graduates have debts of at least $100,000. 87.6% of graduating medical students is indebted with educational loans. Although the average debt of medical students is around $100,000, this does not include interest charged by loan companies. Including interest, students can easily sustain educational debt loads of over $200,000. Such an enormous amount of debt can take up to 20 to 30 years to pay back because loan companies apply most of loan payments to interest rather than the prinicipal balance. The result is that graduates suffer to pay back loans for a number of years because they are "swimming against the stream of interest" which loan companies profit from.

These staggering figures bear witness that new physicians starting careers with a salary of $150,000/year are not inclined to establish practices in underserved areas. The average family practitioner, after spending a minimum of eight years training in college and medical school, incurs an astronomical amount of debt. A new doctor will be expected to owe student loans of at least $150,000 not counting interest to be paid out over 15 to 30 years. The new doctor typically aspires to develop personally and take on new responsibilities of raising a family, which may include a residential mortgage, raising children, and other expenses. These additonal expenses can easily approach $250,000 or more on top of the educational debt of $150,000. If a new physician wants to be independent and start a solo-pratice, he or she will have to raise even more money to start his or her business. It is not unrealistic that new physicians can incur a debt in excess of $600,000 or more depending on the risks they take. That is why the trend for establishing solo-practices has decreased because new physicians have incurred an excessive amount of debt and are dependent on group practices in order to minimize their debt.

Concentrating physicians in group practices is also worrisome because it only exacerbates the physician shortage issue. Ideally, one physician is trained to service tens of thousands of people in a community but if a number of doctors is concentrated in a particular area (i.e. - a suburb), then other communities suffer because the distribution of physicians is poor.

In order to properly address these difficult issues facing our medical industry, Flood International Consulting Agency (FICA) vows to be part of the solution. We have already started in our great State of Louisiana to find solutions to these problems. Through special lobbying efforts the FICA team is working hard to encourage the Louisiana government to build a new U.S. medical school. This new medical school will be unlike any other medical school in the U.S. and will focus to solve the physician shortage problem while reducing or eliminating the debt loads of new physicians in training. The FICA team has created a proposal for a new paradigm model for a 21st century medical school in Louisiana. It is designed to benefit our Louisiana communities through a cooperative effort from our local businesses and organizations. According to key national healthcare policy makers, our model of medical school intimates the direction for the future of the healthcare industry. I believe together we can seek innovative and creative means to satisfy the healthcare needs of our state.

I believe we can all agree that the need for increased collaborative efforts to enhance Louisiana's healthcare is essential. With cooperation from our political leaders and business sector, Louisiana 's citizens become the beneficiaries of quality healthcare and economic stimulus.

If you are interested in helping solve health care disparities in the State of Louisiana while modeling future programs for our nation, please contact us today.

Sincerely yours,

Jarrett S. Flood, M.D.
President
Flood International Consulting Agency

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