Corey Bichel, a volunteer at Lawrence Memorial Hospital, helps Denise Martinek load a cart of files into her vehicle in this September 2007 photo.

An aging population and a doctor shortage. It’s a prescription for inadequate health care.

That’s what Kansans are facing during the next decade if leaders don’t step up with a cure.

Dr. Glen Cox, vice dean and senior associate dean for educational and academic affairs for Kansas University Medical Center, said the shortage of doctors is expected to swell to 25 percent statewide and 30 percent nationwide during the next decade unless measures are taken.

“There are shortages in a number of specialties,” he said. “Primary care is exceedingly difficult to find in a number of areas – not just the classic, rural underserved areas, but also in urban areas. It is very difficult to find a primary care physician.”

He said there are two reasons for the shortage: an aging population and changing work force.

Gene Meyer, president and chief executive officer of Lawrence Memorial Hospital, said industry experts predict it is going to take twice as many doctors to replace those who are retiring.

“We are experiencing shortages because physicians coming out of their training programs have so many options,” he said. Doctors are opting to go into specialized areas that don’t require as many hours and pay better.

If suburban and urban areas are having trouble recruiting doctors, how are the rural areas holding up?

House Speaker Melvin Neufeld, R-Ingalls, said not well.

“We have a physician about one day a week in Gray County for 4,000 people,” he said. “The rest of the time is covered by nurse practitioners.”

During an August meeting in Gray County, Neufeld was approached by a father who said he had been unable to find care for his ailing 2-year-old son in Cimarron, where the nurse practitioner was out of the office on the day he needed help. He drove 18 miles to Dodge City, where doctors were booked for the day. He ended up taking his son to the hospital emergency room, where he was billed $1,500.

“When that happens, that’s bad enough to happen to a father with a young child. When that’s an area that happens over and over to people in their 80s, then it becomes a problem for us retaining people in our community,” Neufeld said.

Training more doctors

Short of hiring trained physicians from other countries, Cox said colleges such as KUMC need to increase the number of positions in their graduate medical education programs. KUMC trains about 675 residents per year in Kansas City and Wichita.

But increasing that number is not something that can be done overnight. There’s a national accreditation process.

“We have to preserve, at all costs, the education of those young physicians and ensure that there’s adequate faculty support, oversight and that they are exposed to diverse clinical settings,” said Amy Jordan Wooden, senior director for public affairs at KUMC.

“We know that we need to increase the number of residents that we train,” she said. “That’s one of the reasons we are actually looking to have partnerships with additional hospitals in addition to our hospital, KU Hospital.”

KUMC is in negotiations with St. Luke’s Hospital in Kansas City, Mo., and KU Hospital. Jordan Wooden said those partnerships could increase the number of residents by 100 at each hospital. It also is looking at increasing the numbers in Wichita.

Neufeld said that while he supports training more residents, he questioned how the St. Luke’s affiliation would help Kansas.

“When they finish training, they are more likely to go to work in the area that they’ve been trained in,” he said.

When asked where KUMC would turn if such affiliations failed, Cox replied that this is a major social issue.

“Ultimately, society, the legislatures and the government are going to have to determine whether they want to face the possibility of not having an adequate health care system in the future,” he said.

Increase incentives

Cox also said there needs to be more incentives for students to enter the health care field.

“Here in the state of Kansas, the amount that we pay residents in terms of salaries, benefits and what have you, is about at the 25th percentile lower quarter of all residency programs in the country,” he said. “So in a certain sense, we are not terribly competitive at attracting the broadest pool of applicants that we would like to be able to attract.”

Jordan Wooden said KUMC’s biggest incentive for students is the Kansas Medical Student Loan program, which forgives student loans for those who go on to work in underserved areas in Wyandotte County and rural areas. Up to 120 scholarships, worth $25,500 a year in tuition plus a $2,000 monthly stipend, are available each year. For nonresidents, the tuition is $43,000.

Neufeld said while the program has been successful, it “doesn’t really solve our problem.”

The program doesn’t benefit Lawrence Memorial Hospital because Lawrence isn’t considered an underserved area. Meyer said the hospital started its own program this year to lure pre-medicine and medical students to the Lawrence area. The staff interacts with students who have some connection to the hospital. They talk about what the community has to offer and try to direct students to specialties where the community is lacking.

Meyer said many undergraduate students volunteer at the hospital as part of their preparation for application to medical school.

“So, we almost have a captive audience to talk to those folks about, ‘Gosh, when you are done with medical school and you’re done with residency … we would like you to consider Lawrence when you get through with your training,'” he said.