Physician shortage in Pima County likely to continue for a while

Tucson has the oldest medical school in Arizona and it has been graduating outstanding physicians ever since its founding in 1967. Tucson is a great place to live with many benefits to practicing physicians such as a cohesive medical community and an attractive cost of living.

Much of the blame can be traced to the Balanced Budget Act of 1997 which froze the number of allopathic and osteopathic medical residency slots as a bumbling way to control health-care costs.

After graduating from a four-year medical school, graduates enter a residency where they acquire most of the practical knowledge necessary to practice medicine.

One of the most important predictors determining where a physician in training will eventually settle and practice is where they complete their residency. By the time resident physicians finish training they have made connections within the medical community and will have been offered several practice positions. In addition, doctors may have started a family during residency and find it much more difficult to pack up and leave.

Obviously a lot has changed since 1997. Before the residency freeze, areas with larger and increasing populations could expand the number of residency spots to meet anticipated needs. Twenty-one years ago, Pima County had a population of about 800,000, but today we have grown to more than a million people with predictions calling for even more population growth in the coming years as Rust Belt cities have seen their populations shrink by up to 30 percent.

Unfortunately, the physician shortage is only going to get worse in Pima County since it takes at least three years to train a new physician once they have graduated from medical school.

Urgent care clinics have had an important role in mitigating the effects of the physician shortage, but they are limited in scope, particularly in addressing chronic diseases such as diabetes or hypertension.

To assist in rectifying the physician shortage, local hospitals have taken it upon themselves to fund additional residency slots. Banner University Medical Center, for example, has made a major financial commitment to fund more than 100 residencies in Pima County. Yet, the federal government continues to use tax dollars to underwrite residencies in areas not experiencing the acute physician shortage such as ours.

Since the residency cap was enacted, our political leaders, especially those representing growth states, have done a pitiful job planning for the health-care needs of their constituencies.

For years, physicians and health researchers have been pressing leaders at all levels to fix the problem but without success. Hopefully, as the physician shortage in Pima County becomes ever more acute, Arizona politicians and others will prioritize fixing this preventable, anticipated and reparable problem.