PUBLISHED: 3:17 PM on Wednesday, February 28, 2007
No quick answer to Alaska doctor shortage

Need a doctor?

Better hope you live in Juneau or Anchorage, because for most of the rest of Alaska, the doctor is not in.

Alaskans in most of the state are receiving health care far below that of other Americans because there are simply not enough Alaska doctors to go around.

Last week a panel of state medical experts described our state's shortage of doctors as "grim."

That's grim as in Alaskans are dying for lack of adequate health care.

The state medical association has reported that Alaska needs at least 400 more doctors to bring our level of medical care up to that provided Down South.

Pending legislation would fund training for 20 Alaska medical students per year in the medical schools operated in cooperation with the University of Washington.

That's double the number of Alaska medical students now entering the program each year.

Sen. Lisa Murkowski, speaking to the Eagle River Chamber of Commerce last Wednesday, pointed out that it's not just education that's affecting the shortage.

"We can't grow our own fast enough," she said. "There are not enough in the (medical school) pipeline.

"And most (new doctors) stay and set up practice within 100 miles of where they train."

Alaska doctors are getting older, and retiring with no young replacements in the wings.

"Where are they all going?" Murkowski asked rhetorically. "They're retiring."

And their patients are also aging, and suffering the natural increase in maladies that come with age.

Last week a group of Alaska doctors and health care experts told Murkowski in Anchorage that the solution is a lot more complicated than training more Alaskans to tend to our own.

Without teaching hospitals, Alaska can't train interns and there's no guarantee those we're training elsewhere will really come hope to care of us.

"I grew up in Southeast Alaska," Murkowski joked, "And you hoped to not get pregnant while living in Wrangell, because there were no doctors to deliver the babies!"

Today there's far more than convenience or heritage at play for new doctors choosing where to set up practice.

The cost of malpractice insurance alone is keeping many specialties open.

While more than 350 infants are delivered at Bartlett Regional Hospital in Juneau each year and the number of physicians performing deliveries is up from past years, obtaining a full time obstetrician has been difficult.

"It's also about the quality of care," she said. "Some doctors have to see a patient every seven minutes every day to be able to pay their bills. Every seven minutes. What quality of care can you expect in seven minutes?"

It's not just routine medical care either. Emergency care also is at risk.

Each of us is one slip on the ice, one car wreck, one tangle with a crab pot puller or 4-wheeler from a life-and-death crisis-with no one close.

Residents in Juneau are relatively well protected, with a superb medical center, full compliment of specialists and quality emergency services. But even here, many family practices are maxed out, closed to new patients.

The state's departments of labor and education have put a substantial push on training new miners and new construction workers for the future of those industries. But we need as much or more attention on training our next generation of physicians.

The legislation to support more medical students is a good first step, although it will take a long time to show real results.

In the interim, additional funding to recruit and keep more practicing doctors will have a more immediate impact.

It is going to be expensive. But with the many challenges of living in Great Land, having to take your life into your own hands for lack of health care should not be one of them.

Leschper is general manager of the Capital City Weekly, advertising director of the Juneau Empire and regional advertising director of Morris Communications newspapers in Alaska. Email him at