Gastroenterologists in short supply

Photo by Carly Farrell

Photo by Carly Farrell

ALBANY, Ga. - It's no secret that physicians in Georgia are in short supply in general, but the problem seems more so with certain specialties.

One of those specialties is gastroenterology.

At current cancer screening rates, the United States will need an additional 1,050 gastroenterologists by 2020, a January 2009 study by The Lewin Group found. If colorectal cancer screening rates were to increase by 10 percent, the nation would need as many as 1,550 additional gastroenterologists by that time, the firm discovered.

The impact of the report is felt in Albany, as well. Dr. Ira Knepp of Albany Gastroenterology was late for an interview with The Albany Herald because he was interviewing a job applicant for a doctor's position.

Based on the need, his tardiness was warranted.

"When we find someone that is interested in coming here, we drop everything," Knepp said. "Just for the city of Albany, we are in a shortage of two or three gastroenterologists.

"That doesn't count the outlying areas. If we had three more, that would meet our needs more comfortably."

As it is, Knepp said the physicians in place locally are currently operating at 90 percent capacity. In citing The Lewin Group study, he said those figures would translate into several hundred additional doctors just for Georgia.

Colon cancer is the nation's second-leading cancer killer. There are currently 10,390 practicing gastroenterologists in the United States, according to the Lewin report.

Current recommendations call for people who are at average risk of colorectal cancer to be screened beginning at age 50. While cancer rates are high in Southwest Georgia, that does not necessarily mean the region is in more trouble than any other in terms of physician shortages.

"We just feel what the country is feeling more intently because (Albany) is the health care hub of Southwest Georgia," Knepp said. "What we are experiencing is not any different than what is being experienced nationally."

Knepp said he came to Albany not just because of the need, but because of what the community provided -- which may be the key to getting more from his specialty into the area.

"It provided me the lifestyle I'm interested in," he said. "That's the same thing we use to draw people here now. We have a lot of things here."

When asked why there was a shortage of gastroenterologists in the Albany area specifically, Knepp replied, "Name recognition."

"Most individuals usually end up within a 50- to 100-mile radius of where they graduated from," he added. "Also, they all go for training in major cities, especially for specialties like gastroenterology. For a while, (young doctors) are of the mindset that you need to be in a large city.

"So we are competing with larger cities. When competing on a national level, Albany is not a city name people recognize."

Unfortunately, there is no quick fix to this problem.

"These shortages will be with us for a period of time," Knepp said. "With the current climate for health care, there are not as many individuals that will want to go into health care. It's gonna take a lot until we can strike a balance.

"There is not gonna be a quick fix. Even if we want to correct this, it is going to take a financial commitment from the state to increase educational opportunities. There are innovative ways to help compensate, but I don't see a solution in the near future."

Bob LaGesse, senior vice president of physician practices with Phoebe Putney Health System, said the 85,000-square-foot Meredyth Gastrointestinal and Endoscopy Center being built in northwest Albany might help bring in some new blood.

"We are going to attract physicians to the market by giving them a dedicated center," he said.

LaGesse said Phoebe's goal is to recruit four gastroenterologists in the next two years, two this year and two more next year. In order to accomplish this there may be incentives offered such as stipends for students, bridge loans and student loan repayment.

"It won't be easy, but we'll get them," LaGesse said.

Every health care market wants gastroenterologists, which is part of the reason it is hard to get them to Southwest Georgia -- at least from LaGesse's standpoint.

"The fact is that we are not getting any younger, and we're all getting to the age where we need to have (colorectal screenings) done," LaGesse said. "There is an increase of 24 percent in colorectal cancer, which means people will want to get these screenings done."

There are currently six gastroenterologists practicing in Albany. These physicians are not immune to getting older either, which has provided officials added incentive to step up recruiting efforts.

"The doctors are getting older. We have a good group, but we have to replace them," LaGesse said. "The system is trying to make sure we have physicians in the pipeline.

"We don't want to get to the point where the physicians retire (and we do not have replacements lined up)."

In rank order, LaGesse said that gastroenterologists are perhaps the second- or third-most difficult specialty to recruit for.

"Once we get a physician here, we keep them here a long time," he said. "The trick is getting them here.

"(In the future) we see big growth in gastroenterology. All of this is in growth mode."

A study released by the Georgia Board of Physician Workforce in October 2006 showed that there was an average of 2.38 gastroenterologists statewide per a 100,000 population in 2004. The report also predicted that there would be 225 physicians in that specialty statewide in 2010, making for a deficit of 159.

Showing an improvement in 2004, gastroenterologists had two regions, metro Atlanta and Augusta, that matched or beat national rates -- with the remainder of the state experiencing a shortage.

The region the Albany area was under, Region 10, fell under the state rate at 2.2 per a population of 100,000.