Emergency Room Docs Dwindling, OSU Study Warns

Emergency Room Docs Dwindling, OSU Study Warns

Shortage of General, ER Surgeons by 2010

OhioNewsBureau

with John Michael Spinelli

Columbus, Ohio: Results of a study by researchers at The Ohio State University warn that by as soon as 2010 there may not be enough surgeons in U.S. hospitals to treat the critically injured or chronically ill.

Study co-author Thomas E. Williams, clinical associate professor of surgery at The Ohio State University, says the number of available general surgeons, who often perform life-saving operations on patients in emergency rooms, will not keep up with public demand. A retired thoracic and cardiac surgeon, Williams, whose study projections were based on data from the US Census Bureau and the American Board of Surgery and included population statistics and projections, medial school graduation rates and information on the number of surgeons currently practicing, said that as the population continues to grow, there will be a shortage of 1,300 general surgeons in 2010. He warned that that shortage will worsen each decade, reaching a deficit of 6,000 by 2050.

"That means people will have to wait longer for emergency treatment and for elective general surgery," he said.

A big difference between selecting and training doctors here compared to other countries where the state pays for their medical human infrastructure, is that US students should expect to leave medical school with between $125,000 to $150,000 of debt. The overwhelming costs of obtaining a medical degree are a large deterrent for many young students, despite scholarships and financial aid, Thomas said to OSU research communicators.

“People may wait hours in an emergency room if there is a shortage of surgeons. But the problem is that if you’re not operated on within a few hours, your disease progresses and that can create more serious problems in other areas of the body. These are problems that you would not have had with prompt surgical attention.” [Thomas E. Williams of OSU]

General surgeons are called upon in emergency room to determine whether or not to operate on a patient. Increasingly, the medical professionals are choosing to specialize in other fields such as cardiac or orthopedic surgery; thereby creating the shortage of general surgeons that will directly impact emergency rooms around the country, which rely on general surgeons.

The shortage calculated by Williams and Ellison derived from the difference between the number of retiring surgeons and those entering the workforce. They compared this number to the expected need for general surgeons. Statistics show that 7.53 general surgeons are needed for every 100,000 people to keep the current level of care. Sadly, their study shows this number will not be met as early as 2010.

There are about 21,500 general surgeons practicing in the United States today. Each surgeon practices for an estimated 30 years and about 705 surgeons die or leave the workforce every year for personal reasons or retirement, their study showed.

Meanwhile, nearly 1,000 new surgeons enter the workforce each year. But of that number, only 850 will practice general surgery. After accounting for retiring surgeons, that means only 145 new general surgeons will enter the workforce. This is far less than is needed given the continuous rise in the population.

As doctors continue to specialize, contributing to an even larger shortage of general surgeons, Williams said it will cost $62.5 million per year ($750 million total) to train the additional 1,875 general surgeons needed by 2020.

Overcoming barriers to minting more doctors and medical schools to produce them are daunting. Williams said the "overwhelming costs of obtaining a medical degree are a large deterrent for many young students, despite scholarships and financial aid."

More problematic is that students required to train as residents are often paid about $45,000 while their professional cousins, lawyers, can land a cool $150,000 to $200,000 per year right out of law school.

Lawyers can work weekdays, with some evening and weekend work when needed, but medical interns can expect to work nights, weekends and uneven hours for up to seven years for considerably lesser pay.

Williams said what needs to be done is to make this profession more attractive through programs to help reduce costs and arranging the 80 hour work weeks to more manageable schedules. "Without these changes, we simply won’t keep up with the increasing demand,” he said.

The duo of Williams and his co-author, Christopher Ellison, professor and chair for the department of surgery at OSU, also co-authored a book with fellow Ohio State professor Bhagwan Satiani, entitled "The Coming Surgeon Shortage: Who will fix our hearts, your hip, and deliver our grandchildren?" OSU communication staff say the book is expected to be released late next year.

John Michael Spinelli is a former Ohio Statehouse government and political reporter and business columnist. To send a tip or story idea to this correspondent, send an email to ohionewsbureau@gmail.com

Ohio Budget Problems Worst in Half Century

Ohio Budget Problems Worst in Half Century

Strickland, State Leaders Gird for More Painful Cuts




OhioNewsBureau

by John Michael Spinelli

Columbus, Ohio: Gov. Ted Strickland and state leaders, facing a worsening financial picture by the day, are girding to make evem more budget cuts on top of current ones, as they try to patch a projected $7.3 billion deficit.

On the Monday after Thanksgiving week that Americans were officially informed that the economy has been in recession for a year, a fact nearly everyone but Washington leaders and the mainstream media understood, Strickland, who came office in 2006 on a platform to "turnaround Ohio" from years of policies devised and pushed by the Ohio GOP, is hoping the slip-sliding state he inherited after 16 years of total control by Republicans, and which has plummeted even further in his first two years, can be bailed out by a new Washington led by President-elect Barack Obama and a Democratic congress.

The news from Strickland's budget director Pari Sabety is that Ohio is expecting a shortfall of $640 million for the balance of the fiscal year that ends June 30, 2009. This figure syncs up with forecasts of a $1.9 billion deficit projected earlier this year. Two budget reductions order by Strickland this year to the tune of $1.3 billion are under way.

“Over the next two years, Ohio will confront the most serious erosion of revenues it has experienced in the last 40 or 50 years,” Sabety said in the Dayton Business Journal. She added that officials are forecasting the first-ever annual decrease in wage and salary income.

Even if all state agencies cut budgets by 10 percent over the two-year budget period, Sabety said the deficit still stands at about $4.7 billion. This effort still accounts for a $2 billion deficit in fiscal 2010 and a $2.7 billion shortfall in the following year.

Strickland won't know how bad things are until after the holiday shopping season is over and sales tax revenues are factored into the size and scope of future budget cuts. With Ohio's economy being what it is, it's tough to a good consumer when you have lost your job or fear loosing your job, as has happened to many thousands of workes across the state.

Strickland's real ace in the hole is President-elect Obama and a sympathetic Democratic congress. Strickland supported New York Sen. Hillary Clinton in Ohio's Democratic primary, but then buddied up with Obama during the General Election.

In his letter to Washington, a city and its leaders who he said is to blame for Ohio's dismal economy, the first-term governor wrote Obama, saying in part: "In Ohio, even though we have already made nearly $1.3 billion in budget adjustments this biennium and most agency spending levels have been reduced to 87.25% of their originally budgeted levels, we are still facing a projected shortfall of $640 million in 2009. Ohioans have sacrificed and have been resilient in the face of the cuts taken thus far. However, additional cuts would be devastating as we are trying to provide basic safety net services during this recession and to stimulate the economy."

He asked Obama and congress to send $100 billion in block grants go to states and $3.2 billion in additional funding under the Temporary Assistance for Needy Families program. The prison psychologist and former Methodist minister also urged the immediate passage of a recovery package.

Ohio is a state whose job base is heavily dependent on Detroit's Big Three automakers and their supply chain. Strickland called for passage of a $25 billion to help out General Motors, Ford and Chrysler, who together employ about 25,000 Ohio workers.

"There will be no national economic recovery without strong states, and I have no doubt that Ohioans, with their resolve and creativity, will do their part and come together in extraordinary partnerships to meet the challenges before us. It is with this collaborative spirit and resolve that I write this letter asking for your partnership. I stand ready to work with you and your incoming administration on this challenge," Strickland concluded in his letter.

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