Healthcare access 'watch list' includes NEPA counties
Published: September 1, 2010
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Although statewide data suggests progress being made with the retention of Pennsylvania physicians, 17 counties demonstrate multiple physician manpower or socioeconomic factors associated with access to care and have been placed on the Pennsylvania Medical Society’s County Healthcare Access Watch List.
According to the 2010 State of Medicine Report from PAMED (www.pamedsoc.org/som2010), physician retention has improved over the last three years and Pennsylvania patients generally have good access to care. But it varies widely across the state and certain counties may need help. It is widely recognized that an adequate supply of physicians and in particular primary care physicians is one prerequisite to access.
As such, 17 Pennsylvania counties have been placed on the PAMED County Healthcare Access Watch List. All of these counties display four or more physician manpower or socioeconomic factors associated with limited access to care and/or have high admission rates for one or more chronic diseases, a possible outcome of inadequate access to care.
All counties were evaluated using 10 criteria that could be an indicator for current or future access to care issues. Placed on the PAMED County Healthcare Access Watch List were Cameron, Clarion, Clinton, Elk, Fayette, Forest, Fulton, Greene, Indiana, Jefferson, Juniata, Lawrence, Philadelphia, Sullivan, Susquehanna, Tioga, and Wayne counties.
These criteria include various physician manpower data metrics and other access indicators such as the percent of county residents who are uninsured, who live in poverty, and who have a high percentage of ethnic or racial minorities.
“On the surface, it’s easy to look at statewide data and say there are no problems because there’s evidence that we’ve reversed the steady decline of practicing physicians that was occurring during the last decade,” said Ralph Schmeltz, MD, chair of the PAMED State of Medicine 2010 Task Force and president-elect of the organization. “But, as you look more closely at the data, you find pockets of the state that continue to have problems, and I’m sure it won’t be a surprise to learn that these are mostly rural counties.”
Dr. Schmeltz points to several circumstances that may have helped improve physician recruitment and retention on a statewide basis. For example, insurance payment for evaluation and management (E&M) codes has not eroded in Pennsylvania to the extent as in other states. And medical malpractice payouts have continued to decline in number and total amount. It should be noted however that in some cases professional liability premiums in Pennsylvania continue to lead premium levels in other markets.
“It’s not a bad day in Pennsylvania,” said James A. Goodyear, M.D., president of PAMED. “But, it’s also not a great day either as some parts of the state continue to hurt. Some steps we pushed for several years ago are starting to pay off now, but there are more steps that need to be taken for the better health of all Pennsylvanians.”
