September 19, 2008
Calais Hospital Examining a Doctor Shortage
By DIANA GRAETTINGER; OF THE NEWS STAFF
CALAIS - The number of doctors needed to meet the needs of patients in Maine hospitals is shrinking and Calais Regional Hospital, like other hospitals, faces a doctor shortage.
Supply and demand is the problem.
"There are not enough [doctors] out there and then you have to say how many want to come to Calais, Maine. That is what we are dealing with, a very small pool," Harrell Connelly, CRH's interim chief executive officer, said recently. He replaced CEO Ray Davis who retired earlier this year.
Calais is struggling.
At its annual meeting in April, the hospital announced that four of its doctors were leaving. The board of trustees also heard that finding replacements would be a challenge.
So far the hospital has hired a pediatrician. "We are currently recruiting for an OB-GYN and two primary care - either internists or family practice," said Camela Griffin, practice manager. Connelly and Griffin were interviewed last week in the hospital's conference room.
She said doctors have expressed interest in the area. "I am optimistic that we will get either one or all three of the physicians by the end of the year," she added.
The hospital now has 16 physicians on staff; of those, nine are employed directly. "We also have physicians who are in private practice and are on staff," Griffin said. Three of the primary care physicians are based in Eastport and four are in Calais.
Scott Towle of Quorum Health Services told the trustees at the April annual meeting that a growing number of doctors were approaching retirement age, and hospitals were having difficulty recruiting physicians. He noted that the problem was worse for rural areas because most doctors weren't interested in practicing there.
Only 10 percent of new graduates want to practice in an area with fewer than 50,000 population, Towle told the board of trustees. The hospital serves northeastern Washington County, which has an approximate population of 14,000 from Topsfield to the north, Wesley to the west and Eastport to the south.
Before doctors decide on an area, Towle added, they look at geographic location, lifestyle and financial packages. They also want to be in single specialty groups and no longer want to be sole practitioners.
Asked what the ideal number would be for the hospital to have a full complement of physicians, Connelly said that question would be decided in the future. "It is one of the items that will be done as part of the annual planning event that this hospital will be doing just as soon as they get a new CEO on board," he said.
The hospital is searching for a new CEO to replace Davis.
Although physicians have left, there are temporary replacements. "We don't have a total void there; we bring in interim [doctors] to fill in those offices especially if they are an employed doctor," he said.
The hospital is looking at other options including hiring physician extenders - physician assistants and nurse practitioners. "So I would say they [doctors] are above average in their willingness to work with them, and we will probably look at additional nurse practitioners as physicians indicate their willingness to supervise them, " Connelly said.
Hiring a hospitalist may be another option. "They are physicians who are employed - usually by a hospital - and work solely within the hospital and their role is to enable the physicians to stay in the practice and do more work in their office and not have to come into the hospital and see patients," he added.
That would mean that doctors would not be on call. "Especially those new [doctors] coming out of new residencies right now. They are looking for a different way of life and one of those things is they don't want to be on call," Griffin added.
Hiring hospitalists or physician extenders will be decided once the new CEO is hired and once the hospital comes up with its long- range plan.
But in the meantime, CRH is not alone. "We are not in a void. We have Machias, we have Houlton; they all compete for the same doctor pool, and that is what makes it difficult," Connelly said. "Every hospital needs doctors today, even the ones in Bangor. There is not a hospital right now that I would say has all the docs that it needs."
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