Primary Care Shortage Article


The Crisis: Primary Care Shortage

There is a quiet but impending crisis in our country’s health care system. It’s not the opioid epidemic or health insurance debate, but carries an impact more far reaching.  America faces a significant shortage of primary care doctors.  We don’t have enough today, those we do have are retiring out of the workforce, and as a nation, we are not producing enough to keep up with our needs.  According to a physician workforce projection report released by the Association of American Medical Colleges (AAMC), the United States could be 17% short of primary care physicians by 2025. (If you find it hard to get in to see a physician now, just wait – things are getting worse.)

This estimated primary care shortage will be most acute in rural areas, affecting Wenatchee and our surrounding communities.  Outside large metropolitan areas, where average household incomes are lower, the number of healthcare providers per 1,000 people is forecasted to be half of what it is in major cities.

There are multiple factors that have contributed to the current situation. CVCH Medical Director Dr. Malcolm Butler points to the overall evolution of the medical practice itself.

“Over the past 60 years, the complexity of medicine has changed from a place where all of a doctor’s tools could be carried in a little black bag,” Butler says. “Now it takes a team of doctors armed with advanced data-systems, scanners, and electronic decision support tools to bring state of the art medicine to bear.  Simply put, it is easier for physicians to practice in big cities – better support and better tools, making it easier to provide care to patients who can afford what a physician would like to charge.”

So why would any physician choose to practice outside of a large metropolitan area?

“Because they are smart enough and brave enough to become indispensable in the lives of their patients,” said Butler. “Because they seek happiness and fulfillment through important work and a life of service. Because they are expansive in their thinking, confident in their skills, and view healthcare to be about people, not just parts of people.”

This innovative attitude has become the rallying cry for Columbia Valley Community Health, the Federally Qualified Health Center that serves approximately 25% of the population of Chelan and Douglas counties.  To counter the estimated shortage, the leadership of the organization is bolstering recruitment efforts, not only by expanding the geographic footprint of their search, but through the employ of creative methods. Sarah Wilkinson, PHR, Director of Human Resources for Columbia Valley Community Health (CVCH), hopes to leverage some of the most obvious resources in unique ways.

“Most of the people that live and work in North Central Washington love to be here,” says Wilkinson. “We have implemented some initiatives that will hopefully tap into three powerful resources: 1) our current workforce, 2) the community at large, and 3) the amazing beauty and opportunity our communities provide.”

CVCH first looked internally to its own workforce and offered a referral bonus to all employees.

“Many of our management positions and most of our current providers are not originally from this area,” Wilkinson said. “Many have family, classmates and colleagues who may be looking for new employment opportunities. If we hire a family practice physician who was referred to us by any CVCH employee, we will pay a referral bonus of $5,000.”

Dr. Butler suggested that the same referral incentive be expanded to the entire community in order to cast a wider net.

“There are a decent number of “transplants” here in the Wenatchee Valley from all over the country,” says Butler.  “We would be remiss to ignore this powerful recruiting resource, independent of whether they have any relationship with Columbia Valley Community Health, especially when confronting a worsening shortage.”

CVCH doesn’t have any expectations around the number of candidates they expect to receive through this community-wide referral initiative. They are more interested in finding qualified candidates who align with the mission and vision of the organization. They know that it’s hard to compete against bigger cities, especially those with residency programs, when according to the AAMC, 68% of physicians who complete their medical school and residency in a single state end up staying there to practice. 

While Dr. Butler and CVCH have been working for more than three years to get a family medicine residency established in the Wenatchee Valley, they have not been able to garner the support or partnerships from other local health care organizations. Still, the 44 year-old community health center has a few weighted factors on its side that keeps the team optimistic that it will be able to fill its provider vacancies.

“CVCH was the first health care organization in the Pacific Northwest to achieve the Joint Commission's Primary Care Medical Home certification,” Butler said.  “We have cutting-edge technology, an EHR that is best of breed, and, let’s face it, we live in one of the most beautiful places in the country.”

Columbia Valley Community Health is now offering a $5,000 family practice physician referral bonus community wide. To learn more, please contact Sarah Wilkinson, HR Director, at 509.664.3587. For information about the family medicine residency program or the physician shortage, contact Dr. Malcolm Butler at 509.662.6000.