Tuesday, May 12, 2009

Physician shortage, doctor shortage - Where are All The Internists?

It is generally agreed there’s a desperate shortage of general internists. A recent survey indicated only 2% of medical students pan to enter general internal medicine. The rest are subspecializing in search of higher pay, greater prestige, shorter work hours, and a more balanced life style.

In the May AARP Bulletin, I ran across a table listing the number of internists around the country. I divided the number of internists in each state by the population of each state and came up with the list below. I’m not sure what these numbers mean except internists per capital are concentrated in New England, fade somewhat in the Middle West and South, and are found in fewer numbers in the less populated states.

I’m also not exactly sure why the glory days of Internal Medicine and its differential diagnosis wizards have gone. My own theory is that the attractions and profits of high technology have replaced the workings of the mind. I’m thinking of MRIs and CT scans and other state of the art technologies, including endoscopies, laparoscopies, and intravascular stents and other devices.
I miss conversations and speculations guided by learned logic about diagnostic possibilities. It was akin to Arabian Nights entertainment.

In any event, here is my list of the number of internists per capita, courtesy of the Bureau of Labor Statistics.

States with Number of Internists per capita
1. Rhode Island 1: 2070
2. Massachusetts , 1:2310
3. Connecticut, 1:2339
4. Maine,1: 3146
5. Maryland, 1: 3394
6. Vermont, 1: 4154
7. Ohio, 1: 4230
8. Georgia, 1:4341
9. New Jersey, 1: 4541
10. California, I:5120
11. Minnesota, 1: 1 5132
12. Idaho, 1: 5161
13. South Dakota. !: 5172
14. North Dakota, l 1: 5178
15. Wisconsin, 1: 5243
16. Hawaii, 1: 5544
17. Michigan, 1: 5586
18. Illinois,1: 5828
19. Oregon, 1: 6171
20. Alabama, 1: 6179
21. Kentucky, 1: 6421
22. Pennsylvania, 1: 6577
23. Oklahoma, 1: 6951
24. Indiana. 1: 6969
25. Tennessee, 1: 6700
26. North Carolina, 1: 7684
27. Mississippi , 1: 7687
28. New Hampshire,1: 8187
29. New York, 1: 8230
30. West Virginia, 1: 8652
31. South Carolina , 1: 8684
32. Virginia, 1: 8903
33. Missouri, 1: 9207
34. Nevada, 1: 9288
35. Colorado, 1: 9710
36. Texas, 1: 9853
37. Florida, 1: 9938
38. Washington, 1: 10308
39. Nebraska, 1: 10992
40. Montana , 1: 15595
41. Louisiana, 1: 18095
42. Arkansas , 1: 16438
43. Alaska, 1: 22122
44. Iowa, 1: 24719
45. No statistics available on Arizona,
New Mexico, Utah, and Wyoming.

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