Florida Council of 100 offers solution to primary care shortage

Floridians pay doubly for low access to primary health care, a new report finds: illnesses that might not have required hospitalization if they were better managed through primary care cost Floridians an estimated $3.5 billion every year, and people end up with worse medical outcomes.

The findings are in a report distributed this week by the Florida Council of 100, a 62-year-old non-partisan group of business leaders.
The report calls for improvements with four themes:

■Expand the number of clinicians in underserved areas.

■Improve the ease of access to healthcare in underserved areas.

■Increase the awareness of cost-effective healthcare in underserved areas.

■Attract and retain global medical professionals.

Among the findings of the report, two years in the making, is that taking Florida as a whole, we are well below the national average of medical residency seats, and that from 2012-2018, 63% of professionals who completed a medical residency in Florida went on to practice in the state. Hence, more medical residents here would equate to more practitioners here later.

The national average of residency seats per 100,000 state population is 44.85, but Florida lags far behind at 34.89. Compare that with 97.97 in New York, 74.04 in Pennsylvania, 63.46 in Ohio, and 54.94 in Illinois.

“Creating and funding additional primary care residency seats would help reduce the primary care access issues in underserved areas by increasing the overall number of physicians,” the report says.

The deficit in primary care is not spread equally across Florida. More than one in three Floridians live in a Health Professional Shortage Area, meaning that over 7.5 million Floridians lack adequate primary care access, the study found.

Worst-off in the state is low-income Bradford County, where there is just one primary health care provider for every 34,884 people. In Flagler County it’s one per 33,222 persons. In North Jacksonville it’s one per 14,778.

Surprising, one South Florida community is counted in the ranks of the nine most underserved areas of the state. That’s Fort Lauderdale, which the report says has a low-income population that is served by just one practitioner per 12,792 people. Federal regulations say an area is experiencing a medical care shortage if the population-to-provider ratio is above 3,000 to 3,500 persons.

One issue that the report underscores is that the doctors most needed in underserved areas are primary care professionals. Yet that discipline has “a relatively lower salary ceiling as compared to clinicians specializing in certain [other] disciplines.”

Of the 29 physician categories that the report lists, three of the six lowest paid are those that encompass most primary care physicians. Average annual physician compensations are listed at $264,000 for internal medicine, $255,000 for family medicine and $244,000 for pediatrics, groups categorized as primary care.

In contrast, physicians specializing in plastic surgery average $576,000 per year, orthopedics $557,000, cardiology $490,000, otolaryngology $469,000, urology $461,000, gastroenterology $$53,000, and dermatology $438,000.

Lowest paid on average of the 29 categories is public health and preventive medicine, where salaries average $243,000.

Key tools to increase the number of primary care physicians in underserved areas, according to the report, could be to increase funds for a new state loan repayment program for physicians, increase payment caps in the program, enable private and corporate donations for clinician loan repayment, and start a state-level campaign to increase awareness of the benefits that would accrue to future primary care physicians who work in underserved areas.