Doctor deficit

When the University of Utah School of Medicine churned out its first doctors in 1944, more than three-fourths of them marched off to World War II. Many never returned to Utah.

It's been like that ever since.

Persuading Utah-trained doctors to practice here has always been a battle. And it's not a problem unique to Utah; like a volunteer army, the "soldiers" are transferred to a residency here, an internship there. They seldom wind up where they started. Utah has always imported doctors to meet its needs.

But it's hard to import enough of them. A study by the Utah Medical Education Council says Utah will need up to 1,800 new physicians in the next 20 years to maintain current standards — and the number of Utah physicians always falls at the low end of what's considered "adequate." The national Council on Graduate Medical Education says "adequate" is 145 to 185 doctors for each 100,000 residents. Utah has about 155.

The patient base these doctors will treat is not typical; Utah has large populations of the very young and the very old, the two groups with the greatest health-care needs.

Now try meeting those needs during a national health-care shortage.

Not all of the state's doctors are doctoring here, either. Of the 6,695 physicians licensed by the Utah Division of Occupational and Professional Licensing, probably a third do not reside in Utah but maintain credentials to teach or practice here on a limited basis. Some on the list are retired but maintain active licenses.

"Our best guess is that 4,200 to 4,500 are actually (working) in the state," said Mark Fotheringham, spokesman for the Utah Medical Association. That includes doctors who don't provide direct patient care, such as those in public health, administration, education or insurance evaluation.

Even as the state begins to feel the pinch, federal policies are reducing the number of doctors being produced, the MEC report suggests, so competition may get fierce.

"I don't know what we'll do when the needs nationwide outstrip the training capacity," said MEC director Gar Elison. "Our ability to compete will become a problem. If the national supply shrinks, we could get into bidding wars for doctors."