Connecticut’s health care workforce is aging quickly with up to a third of the state’s doctors, dentists, and psychologists approaching retirement age over the next few years, raising significant concerns that an industry already stretched thin could soon reach a breaking point.
Between a quarter and a third of Connecticut’s licensed physicians, dentists, psychologists and alcohol/drug counselors are 60 years of age or older, according to an analysis recently done by the state Department of Public Health (DPH). In addition, in seven of the 10 major licensed practitioner categories, at least 20 percent of the workforce is at least 60 years old.
The graying of Connecticut’s health care workforce comes at a time when many industry experts say shortages of primary care doctors, nurses and other health care professionals are already having an impact on the state, leading to longer wait times for appointments and other access issues.
It also comes as demand for health care services in the state are expected to rise as federal health care reform extends insurance coverage to up to 200,000 more Connecticut residents and the state’s overall population grows older.
“The number of practicing physicians is down, new recruits have fallen off and older physicians are nearing retirement. It really is a perfect storm,” said John Foley, a cardiologist from Waterford and president of the Connecticut State Medical Society.
Concerns about shortages of primary care doctors and nurses is becoming a national issue as states like Connecticut prepare for an expected substantial increase in demand for health care services. But the fresh data on the aging Connecticut health care workforce from DPH represents the first time the state gets a true picture of just how old its medical practitioners are, and the risks faced by the state if it doesn’t begin to build a stronger pipeline to eventually replace the large cohort of docs and nurses reaching retirement age.
Foley said there about 17,000 licensed physicians in the state, but he believes there are far fewer doctors actually practicing medicine here. At the same time, he said, up to 45 percent of Connecticut physicians are at least 50 years old, meaning doctor shortages could threaten the state both on a short and long-term basis.
And Foley said he believes physician shortages are already impacting Connecticut, with patients being forced to wait longer, possibly as much as six to eight weeks or more, to schedule an appointment with their doctor.
A 2009 survey conducted by the Medical Society found that 28 percent of internists and 26 percent of family physicians in Connecticut were not accepting new patients and that, on average, new patients faced a wait of 18 days for a routine office visit.
The problem is particularly acute in heavily populated urban areas and rural areas, where there fewer doctors and patients are required to travel longer distances for treatment.
“We have an access issue right now,” Foley said. “It’s not an issue that is looming. It’s already here.”
And, while DPH said it is difficult to project future workforce demand, demographic factors like an aging population and expanded insurance coverage for many uninsured residents in the state is likely to increase demand.
Connecticut’s 65 years of age and older population is expected to increase by 60 percent from 500,000 people in 2010 to 800,000 people in 2030. Older patients typically require more frequent and complex care. Connecticut’s 65 and older population, for example, is at least three times more likely than younger people to have an inpatient hospital stay, according to DPH estimates.
According to DPH, Connecticut’s health care industry currently faces personnel shortages in physicians, surgeons, specialty areas, nurses and allied health professionals.
One of the main concerns for replacing primary care doctors is that fewer medical students have been choosing that career path, particularly since it doesn’t pay as well as other specialty practices. Large debt burdens from medical school lure recent graduates to higher paying jobs, Foley said.
In addition, the high cost of malpractice premiums and overall high cost of living in the state makes Connecticut a less attractive place for doctors to set up shop.
Potential physician shortages are especially concerning as primary care doctors are being asked to take on much larger roles in coordinating patient care as part of a changing health care landscape.
State lawmakers and many other policy advocates have been studying and considering remedies to the primary care shortage problem in the state, but no coordinated policy has been put in place.
Gov. Dannel P. Malloy’s Bioscience Connecticut initiative does create a loan forgiveness program for medical students who choose to stay and practice primary care and dentistry in Connecticut.
At the same time, the new Frank H. Netter MD School of Medicine at Quinnipiac University, which is expected to open next fall, will concentrate specifically on training students for primary care physician positions.
A nursing shortage in the state is also a concern.
According to the DPH report, hospitals face several significant cost issues involving recruiting and the retention of nurses and high vacancy rates are being seen in specialty fields such as emergency department and psychiatric nursing. Meanwhile, a 2002 report by the U.S. Department of Health and Human Services projected Connecticut will face a shortage of 21,793 nurses by 2020, the second worst shortage in the nation.
Mary Jane Williams, who chairs the government relations committee of the Connecticut Nurses’ Association, said her organization is doing an analysis on the supply and demand for nurses in Connecticut.
Currently, however, it doesn’t appear Connecticut has a nursing shortage because many new college graduates are having a harder time finding a job, taking eight months or longer for them to find placement at a hospital or other medical facility in the state after graduation. But Williams said that has less to do with an oversupply of nurses than it does with older nurses deciding to stay employed longer because of economic uncertainty.
“Older nurses are working longer,” Williams said. “Hospitals prefer to hire nurses that have experience because it is more cost effective than hiring a graduate.”
But, Williams warned, there is a huge pool of nurses nationwide — approximately 500,000 — who are expected to retire over the next decade. And, since the average age of a Connecticut nurse (about 47) is higher than the national average, that retirement wave will wash up on Connecticut’s shores.
“It may look like there isn’t a shortage right now but there are factors that will come into play in the next five years that will create a shortage,” Williams said.
