Bright sunshine, mild winters and miles of golf courses are no longer enough to persuade physicians to relocate here from other states.
That’s just one aspect of Arizona’s growing shortage of doctors, nurses and other health care professionals.
And with the Valley’s population expected to grow by 100,000 next year alone, anxiety levels continue mounting over whether there will be enough professionals to care for everyone here.
"Across the country there’s a huge shortage of health care workers, and we’re certainly experiencing that in Arizona," said Gerri Twomey, senior vice president of people resources for Banner Health, the Valley’s largest health care employer. "It’s a highgrowth market. Lots of facilities are adding beds and new facilities are being built across the city, which makes an even greater demand for health care workers."
The health care industry is constantly hiring and trying to recruit qualified persons to fill critical openings in patient and nonpatient health services. While most other industries cut back during the post-9/11 recession, demand remained strong in health care.
For every 100,000 residents in Arizona, there are 207 physicians, about half as many as in Massachusetts, New York and Maryland, according to the American Medical Association. The national average is 283 per 100,000.
Arizona ranks 27th in health services employment, 51st in employed registered nurses per capita, and 49th in pharmacists per capita.
Improved access to education/training will continue to play a role in providing more health care professionals for the populace, but eventually that will reach its limit, said Pat Harris, district director of health care education for Maricopa Community Colleges.
"There’s going to be some creative solutions come out of this because people go into health care because they’re committed to delivering safe, quality care for all patients," she said. "So minds will begin to work on how we can do this creatively before people begin to suffer. The public health of Arizona is of primary importance to all of these people."
A TOUGH SELL
About 90 percent of the state’s 12,000-plus physicians come here from out of state, according to the Arizona Physician Workforce Study. It was completed by the School of Health Management and Policy at the W.P. Carey School of Business at Arizona State University.
"We currently have two medical schools in Arizona (University of Arizona Medical School and Midwestern University)," said Dr. Mary Rimsza, a research professor in the School of Health Management and Policy, and a coinvestigator of the study. "They graduated 196 physicians in 2000, which is 3.9 per 100,000 population. The national average is 6.4 per 100,000, so we’re about half of what the national average is."
Both medical schools are flooded with applicants, so there’s no shortage of interest, she said.
"What we need to do is work on expanding the number of residencies and medical school positions," Rimsza said. "Of course, the residencies would help more than the medical schools because they’d be closer to actually being able to go into practice. Physicians tend to be more likely to stay and practice in a state where they did their residency training."
As for convincing doctors in other states to come to Arizona, that’s becoming increasingly difficult, said Andrea Smiley, director of communications for the Arizona Medical Association.
One of the biggest reasons physicians are shunning Arizona is low health plan reimbursement, she said. Arizona is a heavily managed-care state, which means a larger than average percentage of residents are health plan members, she said.
"The health plans contract with the physicians to take care of those beneficiaries, so they’re the ones who pay the physicians," she said. "Their payments have been either going down, have remained flat or are expected to go down. And that makes it unattractive for physicians to either come here or stay here."
Arizona has a high uninsured population who either rely on the state’s Medicaid program (Arizona Health Care Cost Containment System) or don’t have any coverage and receive free treatment in the hospital emergency departments, Smiley said.
There’s no shortage of Arizonans wanting to become nurses, but there’s a long line of people waiting to get into nursing school, said Bridget O’Gara, vice president of communications for the Arizona Hospital and Healthcare Association.
"The current number is about 1,200 students who are people who want to become nurses and who have been accepted, who are qualified, but there is not room at a desk for them because there aren’t enough educators," she said.
Earlier this year, the Arizona Legislature passed a higher-education spending plan for 2006 that includes $20 million in new spending for a new nursing initiative, Arizona’s Partnership for Nursing Education.
The five-year project will allow the state’s universities and community colleges to add faculty to double nursing school enrollment by 2010.
"There’s a part two to that whole legislation where we are going to ask the federal government and the Congress to allocate the rest of the $20 million so it will be a total of $40 million hopefully that’s coming to address the nursing shortage," O’Gara said. "The goal is to be able to graduate an additional 800 nurses a year during the demonstration program."
In the meantime, Maricopa Community Colleges has increased the number of students enrolled in its nursing program, Harris said.
"In spring 2005, there were 2,100 students enrolled in the nursing pathway program, whereas if you look at spring 2004, there was 2,000," she said.
The graduation rate is also climbing, but will take time for it to match the increasing enrollment, Harris said.
"The professional program is four semesters, so the earliest a student can graduate is 18 months," she said. "So as we begin to add new programs and increase enrollment, our outcome of graduates is 18 to 24 months away."
Of MCC’s 10 community colleges, eight are offering the nursing program and a ninth campus will be on board next year, Harris said.
ACROSS THE BOARD
It’s not just physicians and nurses who are in short supply, O’Gara said. Health care employers are also in desperate need of allied health care professionals, such as respiratory therapists, medical technologists, radiological technologists, pharmacists, occupational therapists, physical therapists and surgical technologists, she said.
"It is across the board, and a lot of that has to do with our population that just continues to grow, and hospitals are adding to their capacity to look to the future to address the needs of their communities," she said.
There’s increasing demand in medical imaging professions as imaging technology continues advancing, O’Gara said.
Also in high demand are medical assistants who work in physicians’ offices, Harris said.
It’s important for the health care community to continue working to put information out there regarding all of the different types of health care careers available, Harris said. It’s not just doctors and nurses, and all positions are critical, she said.
"We’re just continuing to try to develop programs based on community need and industry preference," she said.