By Kimberly Vlach -
Florida needs doctors.
Florida needs jobs.
The health care industry is a breeding ground for employment and economic growth.
Two birds. One stone.
Seems simple,right?
HealthyState.org investigates the economic impact that inadequate health care access has on a community and how the state of Florida could be missing out on an opportunity for growth.
Ask an economic developer what he looks for when surveying communities for opportunities, and he’ll tell you he asks: “How are the schools? And how is the health care system?”
Chances are, in Florida where the over-65 population beats the national average, access to health care isn’t a second priority to the quality of schools. It’s an equal priority.
The reality is, Florida’s 59,000+ physicians are spread across the state unevenly – in a way that creates a surplus of over 9,000 doctors but a shortage of 1,951 primary care doctors. Simply put: metropolitan and suburban areas of Florida have too many doctors, while rural areas that make up most of the state’s geography suffer without.
Out of 67 counties, 17 have only one pediatrician or none at all, according to the Florida Department of Health. There are 23 counties with one or fewer OB/GYNs.
Put aside the difficulties that patients must overcome to get medical help, is Florida missing an economic opportunity?
“When you don’t have health care services or education in a community, it’s difficult to attract business,” said Ann Peton, director of the National Center for the Analysis of Healthcare Data (NCAHD). Health care has a “significant impact” on the economy, both state and local, she continued. If health care is all but non-existent in a community, it’s a “significant loss” to that local economy.
Typically speaking, the health care industry accounts for about 14% of total employment in a community.
But in rural areas, where there is less diversity in industry, health care can account for 20% of employment, according to Dr. Gerald Doekson, director of the National Center for Rural Health Works (NCRHW).
“The health care industry is one of the largest employers and can attract businesses, other industries and new residents,” he said.
One primary care physician generates almost $1 million in payroll from about 23 jobs directly created by him or her, according to the NCRHW. That translates into 3-4 jobs created in the physician’s office, more jobs created at the local hospital in laboratories, out-patient services, other departments like physical therapy or speech therapy, etc.
And then secondarily, there is job creation in the community he or she serves, for example, shops, restaurants, gas stations, etc.
By the NCRHW’s numbers, if Florida can plug the doctor shortage by adding 1,951 physicians to the state, that translates into total revenue of nearly $1.8 billion, creating almost 45,000 jobs.
The salaries that people earn and then spend locally, in turn, creates jobs, Doekson noted.
The Florida Chamber of Commerce echoes that sentiment.
“Job creation within health care means more job creation in other industries which results in higher personal income,” said Teye Reeves, policy director at the Florida Chamber.
When job growth occurs across all sectors at the community level, “this results in expanding the tax base at the local level,” she added.
Ask an economic developer what he looks for when surveying communities for opportunities, and he’ll tell you he asks: “How are the schools? And how is the health care system?”
And if the answers are poor, chances are, it will make a company think twice about relocating.
“Florida has, historically, some of the highest health care costs [in the country],” said Reeves, “which impacts whether or not employers come here and stay here.”
Job creation has been a top priority of Governor Rick Scott, who ran his 2010* election campaign with the slogan, “Let’s get to work.” After he took office, the slogan became “Florida is open for business.”
While it’s too simplistic to argue that job creation in the industry of health care can solve the state’s unemployment rate and fiscal shortages, the data supporting health care job creation in rural areas is noteworthy.
“Governor Scott believes that reducing the cost of doing business for doctors through such things as tort reform, simplified licensure processes and providing a business-friendly climate will help us achieve that goal,” said Jackie Schutz, spokeswoman for the governor.
She added the governor is working with state medical schools to identify ways in keeping the state’s 500 graduating doctors here in Florida, and he’s looking for opportunities to bring more federal dollars into the state to add more residency programs in hospitals.
Research has shown that doctors usually stay where they do their residencies. Residency slots are funded by state and federal dollars, as well as the hospitals themselves. In Florida, there are 244 licensed hospitals, but only 40 of those offer residency programs, most of which are not in rural areas.
“Rural medicine is no different today than it was [in the 1970s],” said Dr. Paul Baroco, director of medical education at Sacred Heart Health System, located in Florida’s panhandle. He started out as a physician in the 1970s in rural Alabama where he worked part-time on the weekends serving the community when he wasn’t at his full-time job with the Navy.
The challenge in rural areas, he explained, is the difficulty in getting access to technology like scans, tests, laboratories, physical therapy equipment, etc. Without those pieces of equipment so vital to administering health care, it’s tough to convince a doctor, even a specialist, to go to a small town, Baroco noted.
Of course it’s easy to oversimplify the solution of creating health care access in rural communities: just put doctors and health care professionals in those shortage areas. The downturn in the economy can’t be ignored and has certainly complicated the mix – health care costs are rising against a backdrop of an increasing number of people who can’t afford health care.
Nonetheless, with a combination of longer life spans and Florida’s rising population, the doctor shortage in underserved areas is an issue that affects everyone, no matter if they’re living in Moore Haven or Miami.
This reporter can be reached at kvlach@wusf.org.
*CORRECTION 14:53 1-26-2012 Governor Rick Scott ran for office in 2010. It was incorrectly stated as 2008.
Comments
It is laughable to whine about the absence of obstetricians in a state with the highest liability insurance rates on earth for obstetricians.