East End community struggling to recruit and retain doctors

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Dr. Ray Diaz

Long Island is facing a shortage of doctors that is putting access to health care at risk, according to a report the Healthcare Association of New York State released last month, which says hospitals are being forced to reduce or eliminate services.

A joint release from HANYS and the Nassau-Suffolk Hospital Council characterized the physician supply on Long Island as “critically low,” warning “the crisis will only worsen in the coming years, as Long Island’s aging physician workforce begins to retire.”

Hospitals on the East End of Long Island are looking to stem the tide by finding new ways to attract young doctors to the area.

The HANYS physician workforce survey says the state had a net gain of 300 doctors outside of New York City in 2007, with half of the increase in Nassau and Suffolk counties. That still leaves a dearth of 322 physicians on Long Island, according to HANYS.

Officials at the two community hospitals that serve the South Fork of Long Island—Southampton Hospital in Southampton Village and Peconic Bay Medical Center in Riverhead—said that this region is not quite in a crisis, but is facing obstacles.

“We’re close to the edge of being critical,” Southampton Hospital President and Chief Executive Robert Chaloner said recently.

“Actually, in the last couple years we’ve recruited more than we’ve lost,” Mr. Chaloner said. In the areas of primary care, such as internal medicine, the hospital has done very well, he said, “but it’s taken a lot of time, money and effort to make that happen.”

There is still a relative shortage of primary care physicians though, said Dr. Fred Weinbaum, chief medical officer of Southampton Hospital. And the further east a medical practice is located, the more difficult it is attract a new recruit, he said. For example, an internal medicine doctor in East Hampton recently left his practice for a job at the hospital and the practice has not been able to replace him as of yet, even with the hospital’s help recruiting.

Dr. Weinbaum pointed out that a few doctors who practice on the South Fork commute from points west, and he said that might become more common since Suffolk County added an eastbound lane to County Road 39 last year.

“The commute into Southampton is bearable now that they fixed the highway,” he said.

Yet Long Island has extremely high malpractice insurance rates compared to rates in other states, and on the East End the cost of entry—buying a home—is also discouraging to young doctors coming out of medical school with a lot of debt, Mr. Chaloner said. Most applicants love Southampton when they come for an interview, he said. “Then when they see the cost of a house, it scares them away.”

Coupled with high prices and high expenses are the low reimbursement rates health insurance companies pay doctors on the South Fork, Dr. Weinbaum said.

Health insurance has also changed the secession of medical practices from retiring doctors to young ones, according to Dr. Weinbaum. “Practices are not as easily transferred from one person to another,” he said.

And patients who draw health benefits from their employers change doctors based on their insurance providers, so patient loyalty is not as prevalent as it was in the past.

On Their Own

When medical practices cannot find doctors on their own, putting a region at risk of inadequate health care, the responsibility falls on the shoulders of the hospitals alone.

“The government really doesn’t play any role in it, unfortunately,” Mr. Chaloner said. “It really is left to the local community hospitals.”

For its part, Mr. Chaloner said, Southampton Hospital has hired professional recruiters and offered housing assistance.

“It’s probably not going to get better anytime soon,” Dr. Weinbaum said. The state of the economy may have softened the rental market, making the area more affordable, but it has also put a strain on the donors who have supported physician recruitment ventures, he noted.

Part of the reason New York City does not have similar problems is that so many medical schools are located there, Mr. Chaloner said. Medical students “often tend to stay wherever they did their medical training and their residency,” he said.

The hospital’s recruitment plan has been in place since it surveyed area doctors in 2006 to determine how many doctors there are in different fields, who is going to be retiring soon and where there are shortages.

“For every problem, you have to come up with creative solutions,” said Peconic Bay Medical Center President Andrew Mitchell.

One method for recruiting and retaining doctors that Peconic Bay and Southampton have both adopted is to incorporate medical practices under “friendly physician corporations.” Under the corporations, the practices benefit from economies of scale and the hospitals provide management, so doctors do not have to worry about the business aspects of practicing medicine.