Thursday, April 08, 2010
The causes of physician shortages

By Dr. Anthony Policastro

One of the concerns that we have had for several years is having enough doctors to take care of all the patients that need to be seen. We have recognized the fact that there is a doctor shortage in the United States. There are several reasons for that. One of them is related to the fact that there are some areas that have more physicians than others. Rural areas such as ours tend to have fewer physicians than are needed. The result is that it is difficult to find a physician or to get an appointment with the physician you have. Another reason is related to the fact that primary care physicians are dwindling in number. The number of individuals deciding to become a primary care physician has steadily decreased over the years. Since 1999, the number of physicians going into primary care has decreased about 40%. Specialists make more money and work fewer hours. Medical students frequently have $150,000 - $250,000 in loans to pay off when they graduate. Therefore, it is logical to become a specialist to pay off those loans without working yourself to death. In 2009, about 50% of family practice residency positions were filled by individuals graduating from United States medical schools. A third reason is that the aging Baby Boomer population will create a great demand for medical services. Now that we have passed Health Care Reform, we will need to have primary care physicians to take care of all the newly insured. Those physicians do not really exist. Therefore, someone may have insurance but may not be able to find a physician. While there certainly can be incentives to encourage medical students to enter a primary care field, that will not happen overnight. The first thing that will need to happen is that the correct incentives have to be found. Help with loan repayment may help. However, the funding is not always there. The State of Delaware has a loan repayment assistance program. However, with budgetary constraints, it cannot provide assistance to many people per year. The same thing is true with other such programs. Perhaps pay can be increased to attract more physicians. However, that will make the system more expensive and the new program will already be expensive enough. Perhaps better work hours can be negotiated. However, if the current physicians work fewer hours, more physicians will be needed to pick up the slack. There are not more physicians to do that because we already do not have enough. Even if we find the right incentives, we need to remember that physicians do three years of residency training after medical school. That means that an incentive program has to be created. It then needs to be put in place. At that point, we would be able to begin training residents under the new program. None of that happens quickly. The result is that the physician shortage is going to worsen significantly as health care reform moves forward. Areas such as ours will feel that shortage both in the short term and the long term.

Free prostate cancer screenings Bayhealth Medical Center will offer free prostate cancer screenings at 9 a.m. on Saturday, April 10 at Calvary Baptist Church in Dover. Prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of cancer deaths for males according to the American Cancer Society. It is recommended that African Americans begin yearly screening at age 40. Others should begin screening at age 50. Family history of prostate cancer in a close relative (father, brother) may also require earlier screening. Bayhealth's two-part screening includes a prostate specific antigen (PSA) blood test and a digital rectal exam (DRE) performed by a urologist. Registration is required. To register, call 744-6752.

Lunch and Learn about diabetes The Sussex Child Health Promotion Coalition Diabetes Prevention and Control Program will hold Lunch and Learns throughout Sussex County for individuals with diabetes and their caregivers. Participants will learn more about diabetes and how to manage the disease. The following area lunches are scheduled:

  • Clarence Street Church of God, Seaford - Thursday, May 20, 11:30 a.m. - 1 p.m. To register, contact Pastor Cannon at 629-9443 by May 14.
  • Laurel Public Library - Monday, May 3, 11:30 a.m. - 1 p.m. To register, call 875-3184.
  • Delmar Public Library - Thursday, May 20, 11:30 a.m. - 1 p.m. To register, call 846-9894 by May 14.

Hospice lunch bunch lecture "How to Reach Genuine Forgiveness" will be the topic of April's Lunch Bunch Lecture offered by the Family Support Center at the Delaware Hospice Center, 100 Patriots Way, Milford, on Friday, April 9, from noon to 1:30 p.m. Dr. Judy Pierson, licensed clinical psychologist, will discuss how to genuinely forgive someone as opposed to just saying "I forgive you" while internally continuing to hold onto hurt and resentment. She'll explore how to bridge the 17 inch gap between the head and the heart to reach the point where both intellect and feelings are in full agreement of this decision. Lunch Bunch Lectures are open to the public. Registration is required as seating capacity is limited, and a minimal donation of $3 per person for the cost of lunch is suggested. Register by calling Vicki Costa, 856-7717, ext. 1129, or email

Prosthetic Parity bill introduced Legislation that would ensure that amputees in Delaware are able to obtain necessary orthotic and prosthetic devices was introduced in the House on recently. House Bill 343, sponsored by Rep. Gerald L. Brady and Rep. Helene M. Keeley, would ensure prosthetic parity for those who have lost limbs by requiring that individual and group health insurance policies provide orthotic and prosthetic devices at a reimbursement rate equal to the federal reimbursement rate for older and disabled Delawareans. As of 2008, 11 other states have adopted prosthetic parity laws. A chief warrant officer with the Delaware National Guard, Rep. Brady noted that the issue of providing amputees with proper devices has gained public attention due to soldiers returning from war with injuries. Coverage for orthotics and prosthetics varies between insurance policies. Some cover 80 percent or more of a medically necessary prosthetic, while others allow a person only one prosthetic for their lifetime. According to the Amputee Support Group of Delaware, the overall insurance industry classifies prosthetics as "durable medical equipment" - the same classification it uses for wheelchairs, oxygen equipment and home hospital beds.

Dr. Snyder appointed to committee The Board of the National Quality Forum (NQF), a nonprofit, organization with a mission to improve the quality of health care for all Americans, has approved the nomination of Peninsula Regional Medical Center hospitalist and Chief Medical Informatics Officer Chris Snyder, DO to serve on their recently established Health Information Technology Advisory Committee (HITAC). This national appointment of Dr. Snyder to the HITAC is for a two to three year term. The HITAC is a standing committee of the Board and will provide strategic guidance and input into NQF matters that activities that involve health information technology. In addition, Dr. Snyder has been invited to present in May at the 2010 Annual National Patient Safety Foundation Patient Safety Congress in Orlando, Fla. Dr. Snyder will speak on Peninsula Regional's use of technology to help caregivers improve patient safety related to the use of high-risk medications using computerized physician order entry (CPOE). The Medical Center achieved an overall 85% adoption rate using CPOE to order medications electronically, update patient records and support process change. The presentation to be given by Dr. Snyder recently won Peninsula Regional the McKesson's Corporation's "Celebrating CPOE Success Award" for best practices in the use of CPOE.

Walk MS at Heritage Shores Heritage Shores in Bridgeville is home to the annual MS fundraiser, Walk MS: Twilight at Heritage Shores. This year's event steps off at the Heritage Shores clubhouse on Friday, April 30, at 6 p.m. "After the walk," promises the chapter's director of development, Holly Maddams, "we'll gather in the grand ballroom and outdoor patio, enjoy some good food and entertainment, and hand out prizes. We're giving a BPA-free water bottle to every participant who raises at least $25 and an event t-shirt to anyone who raises $100 or more." Day-of registration begins at 5 p.m., but advance registration is recommended. For more information, visit or call 655-5610. Free cancer workshop offered The Wellness Community- DE, an affiliate of the Cancer Support Community, and Nanticoke Memorial Hospital present an educational program to cancer patients and their loved ones in western Sussex county. "Coping With the Side Effects of Cancer Treatment" workshop will be presented in the Nanticoke Cancer Care Center Lobby, on Tuesday, April 13 at 4 p.m.

Join Dr. Paul Zorsky and Jaci Burdette, oncology nurse, both of Nanticoke Cancer Care Center, as they present an informational program highlighting the side effects of cancer treatment. Fatigue, blood counts and infections will be highlighted in this very informative educational program. A question and answer period will follow. All classes sponsored by The Wellness Community are offered to people affected by cancer and their loved ones free of charge. Call 645-9150 or 629-6611, ext. 2378 to register.

Spring into Health Walks The Sussex Child Health Promotion Coalition and the towns of Laurel, Bridgeville, Georgetown, Lewes and the city of Seaford have joined together for a fourth year to promote Sussex County's "Spring into Health Community Walk." This walk is being held simultaneously in all five towns on Saturday, April 17 at the following locations:
  • Woodbridge Athletic Complex, 14714 Woodbridge Rd., Greenwood; 8:30 a.m. registration, 9 a.m. walk
  • Seaford Athletic Complex Track, Virginia Avenue, Seaford; 8:30 a.m. registration, 9 a.m. walk
  • Laurel Senior High School, Laurel; 9:30 a.m. registration; 10 a.m. walk
  • Sussex Technical High School, Georgetown; 8:30 a.m. registration, 9 a.m. walk
  • The Villages of Five Points, 17339 North Village, Main Boulevard, Lewes; 8:30 a.m. registration, 9 a.m. walk
There is no cost for this event and it is not a fundraiser, simply an awareness campaign. Special guests will appear around the community. The first 100 children at each site will receive a free t-shirt just for participating. Each location will offer special kids activities and health screenings. The mayor from each town or their representative will be present to read a proclamation on behalf of the town council promoting April 17 as Community Health Day. For more information on the Sussex Child Health Promotion Coalition, call 444-9062 or visit

5K benefits Breast Cancer Coalition The Delaware Breast Cancer Coalition announces its First Annual DE-Feet Breast Cancer 5K Run/1M Walk sponsored by Tanger Outlets will take place on Sunday, May 2, at 9 a.m. The 3.1 mile course will begin and end at Applebees restaurant at Tanger Outlet Center, Rehoboth Beach. The family event is open to runners and walkers of all ages. All proceeds from Tanger's DE-Feet Breast Cancer 5K/1M will benefit the Delaware Breast Cancer Coalition (DBCC). On the heels of a very successful Pink Card campaign in which Tanger Outlets raised more than $90,000 for the Delaware Breast Cancer Coalition last October, Tanger's general manager Amy Norgate eagerly stepped up to sponsor DBCC's 5K event. Advanced registration, which is recommended, is $20/person. On-site registration is $25/person, beginning at 7:30 a.m. on race day; and the first 100 people registered receive a long-sleeve T-shirt. There's even a "Sleepwalkers" category for those who are unable to attend but want to show their support. Sleepwalkers simply register for $20, check the "Sleepwalker" category and then sleep in on Sunday. To register, visit or

Registration open for Walk MS Registration is now open for this year's Walk MS season in Delaware. Organized by the Delaware Chapter of the National Multiple Sclerosis Society, the goal is to raise awareness and funds for the programs and services needed by more than 1,500 Delawareans with MS and their families. Each of the five events takes place on an accessible 5K route, and plenty of support is available as well as the opportunity for lots of fun with family and friends. Two events take place in Sussex County:
  • Walk MS: Twilight at Heritage Shores steps off at Providence At Heritage Shores, One Heritage Shores Circle in Bridgeville, on Friday, April 30, at 6 p.m.
  • Walk MS: Twilight at Baywood Greens steps off at the Baywood Greens Golf Course, 32267 Clubhouse Way in Long Neck, on Friday, May 21, at 6 p.m.
Day-of registration begins one hour before the event, but advanced registration is recommended. For more information or to register, call 302-655-5610 or visit

Hospice plans fundraiser Delaware Hospice's Beef and Brew fundraiser will be held on Friday, April 16, from 6:30 to 10:30 p.m. at the Georgetown CHEER Center. Tickets are $30 per person through Monday, April 12, and $35 per person after April 12 or at the door. Beef and sides will be catered by the Georgia House and beer sponsored by Banks Wines & Spirits and the Starboard. The evening will include raffles, a silent auction and dancing with "The Funsters." Delaware Hospice invites you to participate through sponsorships or donations of auction items. Call Peggy Dolby, 856-7717, or Mary Morgan, 800-838-9800, for tickets or sponsorship information.

Cancer support group The Wellness Community-Delaware offers a free general cancer support group for people affected by cancer and their loved ones at Nanticoke Memorial Hospital in Seaford. The monthly support group meets in the second floor conference room of the Cancer Care Center on the third Monday of each month from 4:30 to 6 p.m. The Wellness Community is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All facilitators of these groups are trained mental health professionals. Call 645-9150 for information or to register.

Man to Man support group Nanticoke Memorial Hospital offers a Man to Man support group meeting on the fourth Wednesday of each month. Man to Man helps men cope with prostate cancer by receiving information and peer support. Man to Man is a forum for men and their support network to learn about diagnosis and treatment options through presentations, written materials and videos. Specialists share information such as side effects and how to cope with prostate cancer and its treatment. News and information about nutrition, general health, research and treatment, as well as messages from men living with prostate cancer and other Man to Man activities, are offered to assist in the recovery process. Pre-registration is not required for this free support group. For more information, contact Larry Skala (337-3678) or Grafton Adams (628-8311).

Depression Support Group There is a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call 302-465-6612.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Together, they answer questions, help calm fears, and share information about resources that are available at Nanticoke, through DBCC, and other organizations within the local community. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Bereavement support group Compassionate Care Hospice, The Wellness Community-DE and Nanticoke Memorial Hospital will collaborate to present a monthly bereavement group, The Next Step. The group focuses on issues of loss that continue beyond the early stages of grief. Mary Van House, bereavement coordinator, will facilitate the group at 10 a.m. on the third Tuesday of each month, at the Nanticoke Cancer Care Center, second floor conference room. To register, call Lisa at 629-6611, ext. 2378.