Fifty-one doctors have left their Wyoming practices this year, and there are 115 physician vacancies, according to a study of the state's healthcare system.
While the report, prepared for the Wyoming Office of Rural Health and obtained by the Wyoming Tribune-Eagle, indicated 728 full-time doctors in the state in September, there were 140 vacancies overall -- 115 for doctors and 25 for support staff.
Based on the number of physicians in the state, one could expect about 30 doctors to retire annually and another 20 or so to leave the state through normal turnover, according to Sen. Charles Scott (R-Casper), chairman of the Senate Labor, Health and Social Services Committee.
"With our mobile society, you expect some of that," he said. "You would expect 50 to 60 vacancies at one time. We have 140. We aren't able to recruit fast enough."
"The report shows, in my judgment, that we are in trouble right now," Scott said.
Depending on the specialty, the report indicates vacancies have existed from two months (for ophthalmology) to 33 months (for gastroenterology).
Reasons cited by medical staff for the 51 physicians leaving included lack of time off (three), family reasons (seven), not liking the area (three), malpractice insurance too high (four), conflicts with the office manager (one) and retirement (four).
One doctor went to part-time work. Other (21) or unknown (seven) accounted for the remainder.
Scott said he wasn't surprised that only four indicated high malpractice insurance. "It's a factor in a much wider group, I think, but only a factor," he said. "Most of the turnover we've seen to date has been the normal movement in our mobile society.
"The difficulty comes not that we're losing, but that we're not doing an accurate job of recruiting."
The state's healthcare picture could worsen in the near future following the defeat of proposed constitutional Amendment D, which would have allowed the Legislature to consider setting caps on noneconomic damages awarded by juries in medical malpractice lawsuits, Scott said.
"My fear is some doctors that have been grumbling and hanging on are going to just give up and say, 'They don't want us here,'" he said.
Scott said medical recruiters have told him the state's lack of a ceiling on damages for medical malpractice makes their job difficult.
Other problems include the state's low Medicare and Medicaid reimbursement rates, he said. He noted that Campbell County, with a population estimated at 36,240 in 2003, has only one general surgeon.
"If she burns out, there's no one left," he said.