Charles Dwyer Remarks-October 17, 2011

Role of the ORHPC  Shortage designation  Support of the primary care safety-net  Health workforce development for rural and underserved communities  Health Workforce Forum  Health professions re-licensure survey activity

Demographics of Physicians from re-licensure survey data  Most physicians practicing in Maine are white males under the age of 54.  Seventy percent of those surveyed have been working for 20 years or less.  Survey respondents work an average of 41.2 hours per week, are on-call for another 19.6 hours per week and work an average of 47.5 weeks per year.  As doctors get older, they cut back on hours and are more likely to work part-time; older doctors also work fewer weeks per year.  Female doctors work fewer hours per week than male doctors but they work the same number of weeks per year, on average.

Demographics of Physicians cont.  Nearly 76% of hospital-based doctors work more than 40 hours per week, compared to only 64.3% of other doctors.  Among physicians at work in outpatient settings, primary care physicians see an average of 9.2 more patients per week than do other types of physicians and are more likely to use electronic records.  If reaching age 65 was the only determinant of turnover, 20% of doctors currently working will retire within 5 years, 37% within 10 years and 54% within 15 years.  Assuming that age 65 is the only predictor of retirement, rural areas in Maine will experience greater retirement- related turnover in the coming years.  Intent to leave within 5 years is correlated with job satisfaction and primary care physicians may be less satisfied with their jobs compared to other physicians.

Current Designations by the numbers  77 Primary Care Health Professional Shortage Areas: 13 Service Area Designations 21 Population Area Designations 43 Facility Designations Total designation population 132,091; Estimated underserved population 63,291

Primary Care HPSA Map

Current Designations by the numbers  74 Dental Health Professional Shortage Areas: 15 Service Area Designations 24 Population Area Designations 35 Facility Designations Total designation population 516,812; Estimated underserved population 221,712

Dental Care HPSA Map

Current Designations by the numbers  44 Mental Health Professional Shortage Areas: 9 Service Area Designations 2 Population Designations 33 Facility Designations Total designation population 196,303; Estimated underserved population 158,303

Mental Health HPSA Map

Health Workforce Programs  National Health Services Corps (Scholars and Loan Repayment Programs)- Professionals contract for a minimum of 2 years in an underserved community in exchange for educational benefits. Currently Maine has 109 NHSC clinicians in service, 62 PC, 24 MH, 23 DH.  Physicians J-1 Visa Waiver Program- Foreign physicians completing training in the United States may remain here if they agree to work in an underserved area for 3 years. (Annual cap of 30 per state). This year there were 28 waivers granted. There are 57 Physicians currently obligated.  National Interest Waiver- Waives the labor certification requirement and fast tracks permanent residency for physicians willing to commit to 5 yrs of employment in an underserved community. Seven are currently obligated.

 Maine Dentist Tax Relief Pilot Program- Dentists that open new practices in an underserved area can have their state income tax refunded for a numbers of years. 6 dentists participate.  Maine Dental Equipment Revolving Loan Program- Provides up to $50,000 in low interest loans for the purchase of dental equipment for use in clinics serving underserved populations.  FAME Dental Loan Repayment Program- Provides up to $80,000 in loan repayment to students or practicing dentists who will serve underserved populations. 8 Dentists are currently enrolled.  Rural Medical Access Program- Collects and distributes funds to offset the cost of medical malpractice insurance for rural providers that offer obstetrical services in rural and underserved communities. 29 Physicians met all the qualifications.