Read this op-ed as it originally appeared on nj.com
The Star-Ledger recently reported that lawmakers in Washington are looking to close a decade’s old loophole that is leading to a doctor shortage in New Jersey.
While New Jersey’s Congressional delegation should be praised for their efforts to overturn the cap on Medicare-funded slots for doctors in training, it is only one of the reasons why New Jersey residents are losing access to medical doctors and surgeons.
American Medical Association data shows that between 2008 and 2016, the number of physicians who trained and then practiced in New Jersey decreased by 2.2 percent. More eye-popping is the age distribution of New Jersey doctors.
New Jersey ranks third highest in the nation for percentage of physicians over 60 and ranks second only to Montana for the lowest percentage of physicians under 40. As our older physicians retire, there are fewer talented young doctors to take their place.
New Jersey is a great state, and doctors want to live here. What can we do to attract and retain them?
First, our lawmakers must ignore the noise from insurance companies and hospital conglomerates and implement changes that physicians know will make New Jersey a desirable state to practice medicine.
The New York University School of Medicine just showed us where to start. By announcing free tuition for all of its medical students, NYU has slashed a massive debt burden for medical school graduates. Starting a medical practice with $200,000 or more in educational debt is a daunting task, especially in a high cost-of-living state like New Jersey. While tuition-free medical education part of the solution, more can and should be done.
The New Jersey Loan Redemption Program permits loan forgiveness up to $120,000 for primary care physicians practicing in underserved areas. This program needs to expand to account for the rising medical school debt burden and include specialists like general surgeons whose numbers are also in decline.
However, increasing the potential supply of physicians will not solve the current physician shortage. More can be done on the business side of the medical profession to attract and retain young doctors.
The New Jersey Hospital Association recently proposed giving tax credits for new individual medical practices. Any lost payroll revenue would be offset by the economic stimulus each new physician brings to the state. This is a positive financial incentive that will lead to increased access to medical care.
Another solution for attracting more doctors to New Jersey is to allow a Medicare-rate tax credit for any emergency services provided to uninsured, indigent patients.
Unlike hospitals that operate under the “not-for-profit” label, physicians receive no tax benefit for providing charity care. A Medicare-rate tax credit would attract young physicians beginning their practices and incentivize existing physicians to provide on-call emergency coverage to our state’s most vulnerable citizens.
Finally, New Jersey needs better compensation models for its practicing physicians. Out-of-network medical insurance plans previously reimbursed doctors using the market-driven FAIRHealth database.
However, the vast majority of out-of-network plans now available to New Jersey residents use the Center for Medicare Services reimbursement rates, an index that provides little financial incentive for physicians to work in New Jersey. New York and Connecticut have chosen FAIRHealth as their benchmark for out-of-network and emergency services.
If New Jersey wants to build a robust physician workforce, we cannot afford to fall behind our neighbors.
At a time when too many of our trained physicians are taking their talents elsewhere, we need to incentivize these bright young minds to open practices in New Jersey. Failure to act will hamper the quality of life not only for medical practitioners but all New Jerseyans.
Lawrence Stankovits, MD, is a pediatric orthopedic surgeon in Shrewsbury and Edison. He is a vice president of the New Jersey Doctor-Patient Alliance.