Oklahoma is facing a shortage of doctors, and University of Oklahoma and Oklahoma State University officials say things only will get worse unless steps are taken to address the problem.
Citing an aging physician workforce and a growing pool of Medicaid patients, officials from the OU School of Community Medicine and the OSU Center for Health Sciences say the state needs to ramp up efforts to recruit and train more doctors to meet the needs of underserved areas, particularly in rural Oklahoma.
A New England Journal of Medicine article ranks Oklahoma as the state that faces the most challenges in meeting medical needs. That ranking is based on the ratio of Medicaid expansion to primary care capacity.
Rising Medicaid need
According to the article, Oklahoma is expected to see a large expansion in the Medicaid population as the federal health care law takes effect. But Oklahoma doesn't have the primary care capacity to deal with those newly insured patients. Without outside efforts, the demand for medical care could outstrip the supply of providers in the state.
Oklahoma's health is already poor, said Gerry Clancy, president of OU-Tulsa and dean of the School of Community Medicine. As the increasing demand for care continues to put pressure on doctors, the state's overall health will continue to deteriorate, he said, particularly in areas with few or no doctors.
Residents in those underserved areas could see shorter life expectancies, Clancy said. Those residents also tend to delay seeking medical attention, he said, meaning they eventually wind up in emergency rooms. As a result, emergency rooms fill up, making it more difficult for trauma patients — such as patients who have been in a car accident — to get care quickly, he said.
A new health ranking appears to bear that warning out. America's Health Rankings for 2011 place Oklahoma at No. 48, two spots lower than the previous year's rankings. Only Mississippi and Louisiana fell behind Oklahoma in the rankings, which are released annually by the United Health Foundation.
The rankings cite a high prevalence of smoking and obesity, limited availability of primary care doctors and low use of prenatal care for the low ranking.
What's being done
Officials from both universities spoke to the Oklahoma State Regents for Higher Education last week about efforts to put more doctors in rural Oklahoma.
Clancy, along with OU President David Boren, told the board they're working to expand the Tulsa-based School of Community Medicine and build a partnership with the University of Tulsa. OU-Tulsa's physician's assistant program has collaborated with TU since 2009, Clancy said, and expanding that partnership to include the School of Community Medicine could be good for both parties.
TU brings a number of assets to the partnership, Clancy said, including established basic science programs that OU doesn't offer in Tulsa. The university also brings high-
OU officials began planning the School of Community Medicine in 2007, Clancy said, and began working with TU on the expansion in 2009. The school is different than the Oklahoma City-based OU Health Sciences Center in that the Tulsa school focuses specifically on meeting the needs of underserved populations and rethinking the way the health care system works.
One of the ways the system is changing is through the use of medical informatics, or computer software used to enhance care. Recently, Clancy said, a professor developed a program that uses secure Web connections to allow primary care doctors to reach specialists for consultations. The specialist may then simply answer a question or ask to see the patient in person.
Much of the time, Clancy said, doctors are finding that they avoid referring patients to specialists simply by talking to the specialist beforehand. That helps alleviate the strain on specialists, who tend to be in high demand, Clancy said.