In 2011, Dr. Timothy Siegrist had just finished his residency training in urology in New York City. He and his wife wanted to move back to Connecticut, where they were both originally from.
Siegrist interviewed at five urology practices across the state before settling on one in Middletown, where he’s been ever since.
A decade later, four out of those five practices, including his own, now belong to larger health care corporations.
“The No. 1 reason they were unable to remain independent was the inability to recruit new candidates to their practice,” he said. “In my experience, unless a candidate has family ties that compel them to return or remain in this state, it is nearly impossible to attract new physicians to Connecticut.”
Connecticut health providers say the state’s lack of incentives, burdensome malpractice requirements and high costs of living make it one of the most unappealing places to begin practicing medicine. It makes for a precarious situation as health care demands rise and the physician retirement population grows.
“The burdens of care during the COVID pandemic have stretched an already thin margin even further,” said Siegrist, who serves as president of the Connecticut Urology Society. “We are seeing record numbers of providers of all types planning to reduce care or leave practice entirely.”
A report from the Association of American Medical Colleges estimates that there will be a shortage of between 37,800 and 124,000 primary care and specialty care physicians nationally by 2034. It would put access to health care services at risk, particularly in marginalized communities, rural areas and low-income neighborhoods.
To get ahead of that, Connecticut lawmakers are considering a bill that would make some short- and long-term investments in physician recruitment and retention. Health providers spoke of their support and recommended some changes for the legislation during a public hearing Monday.
Dr. Mona Shahriari, a private practice dermatologist in Cromwell, said there are many reasons why Connecticut medical students eventually leave the state after completing training. She teaches medical students at UConn and Yale schools of medicine.
“What they find is that there’s just so much red tape and bureaucracy and other measures that make it hard to be a doctor [here],” Shahriari said. “They keep seeing constant changes and struggles within our state, and they don’t see those struggles in other states.”
Dr. Bob Russo, chief medical officer of the Connecticut State Medical Society, said that’s not to mention one of the biggest concerns among practitioners entering the workforce: student debt.
“It’s not only the outrageous expense of medical school, but a lot of medical students are carrying their [undergraduate] college debt forward,” he said.
Nearly three in four medical students graduate with debt, according to the Association of American Medical Colleges. The median debt amount in loans was $200,000 in 2019.
Legislation before the General Assembly’s Public Health Committee would establish a physician loan reimbursement grant program. To be eligible, a person would need to be licensed and employed in Connecticut and have either graduated from a medical school in the state or completed a medical residency program at a licensed Connecticut hospital.
Reimbursements would apply to all federal and state educational loans and be in the amount equal to 20% of the balance of those loans per year.
The bill also proposes a physician recruitment grant program that would offer $20,000 for physicians who relocate to Connecticut as full-time providers for at least two years.
Under the legislation, a task force would be established to review the state’s medical malpractice policies and identify possible reforms that would lessen the burden on physicians. The task force would submit a report with their findings by Jan. 1, 2023.
Some physicians who testified Monday expressed support for a part of the bill that would waive license renewal fees for three years. However, Dr. Manisha Juthani, commissioner for the state Department of Public Health, said that would result in a $9 million loss annually to the state.
“I think that would be a very big hit for us,” she said, “so, I think that would be a tough one to really swallow.”
Other health providers in written testimony said the loss of these funds would negatively impact organizations and programs that rely on these state dollars to offer support services to health care workers.