Report: Utah doctors 4th most overworked in U.S.

Stock image | Photo courtesy of Pixabay, St. George News

ST. GEORGE — Utah doctors and nurses are some of the most overworked in the nation, according to a new report that compares the number of professionals to the state’s population. But local medical professionals say there are other factors to consider.

The 2018 Medicare Health Plans report finds that the state has the second most overworked nurses and the fourth most overworked doctors in America.

Analysts used population data from the U.S. Census Bureau and the Kaiser Family Foundation and compared it to the number of doctors and nurses in the state to determine how many medical professionals there are per 1,000 people.

“With so many people compared to the number of doctors and nurses, we can assume that these health care professionals have a lot of work to do,” Joshua Adamson of Medicare Health Plans said in a press release.

In Utah there is an average of 5.7 nurses and 2.1 doctors per 1,000 people. The U.S. average is 12.8 nurses and 2.8 physicians per 1,000 people.

The study attributes this to Utah’s high birth rates, longer life spans and the retirement of baby boomer doctors.

Intermountain Dixie Regional Medical Center, St. George, Utah, July 18, 2018 | Photo by Mikayla Shoup, St. George News

According to the report, the state with the most overworked nurses is Hawaii with 1.9 nurses per 1,000, and Idaho has the most overworked physicians with 1.7 doctors per 1,000.

Not only does being overworked lower job satisfaction for medical professionals, it can also lead to errors that affect patient outcomes, according to the report.

Intermountain Dixie Regional Medical Center Medical Director Steven Van Norman said that while, yes, at any given time there are doctors who are overworked in the U.S. as a whole, there are also many doctors who are not. He said that simply comparing the number of doctors per thousand people does not provide an accurate picture as there are many other factors to consider such as a physician’s specialty and location.

As the state with the youngest median age, Utah’s health care needs often differ from other states. Terri Draper, communications director for Intermountain Healthcare, said that because of the younger population they may not need as many physicians.

Utah’s citizens are also healthier than most, deemed the fourth healthiest state in the U.S. according to a 2017 United Health Foundation report.

St. George’s fast growth rate is another reason why they may have fewer medical professionals per thousand, but it appears to be balancing out. In the past, Dixie Regional Medical Center has had to employ traveling nurses to help keep up with the number of patients, but for the last several months it has been able to rely on its regular nursing staff.

Van Norman said that while physicians do work hard, the large amounts of paperwork and regulations that takes them away from their patients is often the main cause of burnout.

None of us went into medicine because we thought it was easy, or we wanted to cruise along. We went into this with the idea that we were going to work hard,” he said.

Thomas Told, dean and chief academic officer at Rocky Vista University, a private medical school in Ivins, agrees that medical professionals are overworked in the state. Especially in smaller communities like Southern Utah.

Told attributes Utah’s physician shortage to the large number of doctors who are retiring, and that there are not enough medical students to replace them.

It’s not because of a lack of medical schools, he said, but a lack of residency programs for graduates. And while many medical students in Utah would like to stay, if they go elsewhere for their residency they will most likely stay to pursue a career.

Rocky Vista University, College of Osteopathic Medicine, Ivins, Utah, July 10, 2018 | Photo by Mikayla Shoup, St. George News

Rocky Vista is working with local hospitals to provide more postgraduate training to try to keep future doctors in Southern Utah. Its goal is to make medical postgraduate training programs part of hospitals’ mission.

Another contributing factor to the lack of residency programs is lack of funding. Most of the financing for residencies comes from the federal government’s attempt to keep a neutral budget, which has not kept up with the population increase.

“There are three things that help communities survive. A good recreation system, schools and a quality healthcare program,” Told said. “I think the state needs to look at those three things as what makes a community thrive.”

Van Norman also attributes having fewer doctors to a lack of residencies. Not only a general lack of residencies, but a limited selection for the type of programs offered. He has seen many physicians start out hoping to become a primary care physician, but end up in a specialty due to residency options.

Dixie Regional Medical Center does not have any residency programs, lacking sufficient funding to become a teaching hospital.

The hospital may not be able to teach physicians, but it does train nursing and technical professionals. Many of these employees were students at Dixie State University.

“Dixie State University has been such a tremendous community partner in supporting the workforce,” Draper said.

The hospital’s main shortage is with primary care physicians who are able to see Medicare patients. Since Medicare tends to pay less than private insurance, many physicians have to limit the number of Medicare patients they see.

Because of the financial burden, the hospital has had to take more of a team-based care approach when it comes to seniors. Draper said that Intermountain is looking at new options for providing health care for senior citizens.

Since seeing a primary care physician is more beneficial to senior patients, the hospital has begun a new program to help fund the recruitment process for local practices looking for internal medicine doctors to treat patients with Medicare.

Two years ago, Intermountain introduced the Connect Care app, allowing patients to connect with a physician digitally anytime. There are six primary care providers dedicated to helping patients online, which has alleviated the workload of other physicians. This year alone, 13,168 Intermountain patients had used Connect Care as of July 15.

Intermountain has also implemented programs to help people live healthier lives, thus reducing the number of patients each doctor will see. The first is the LiVe Well center, which helps people learn how to live healthy lifestyles through behavioral changes like diet, exercise and stress management. They also recently formed the Utah Alliance for the Determinants of Health, which aims to address social determinants of health like hunger, abusive relationships and paying for utilities.

Read More: New alliance seeks to improve health by addressing nonmedical factors

“In the U.S. in general, we’re incredibly good at rescue care. You fall off a cliff, the U.S. is where you want to be,” Van Norman said. “But instead of continuing to build more nets at the bottom of the cliff to catch the fallers, we’ve got to start pushing people back from the edge of the cliff.

Because it can’t offer residencies, Intermountain uses other means to recruit physicians to work there. It places ads in journals and sends representatives conferences. It also offers student loan reimbursement for internists and offers higher salaries. Utah as a whole offers nearly $10,000 more per year than the national average, according to the report.

While Intermountain will continue to try to prevent physician overwork, officials there recognize that it is not just about hiring more professionals.

“Long term, how we meet this need probably isn’t just by increasing the number of providers. We have use them more efficiently,” Van Norman said.

Email: mshoup@stgnews.com

Twitter:  @STGnews | @MikaylaShoup

Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.

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1 Comment

  • Mike P July 22, 2018 at 8:22 am

    “With so many people compared to the number of doctors and nurses, we can assume that these health care professionals have a lot of work to do,” So, no hard data, so we’ll just “assume”.

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