Are we facing a general shortage of health care/public health workers in Maryland: implications for emergency management training and education

Reading this got me thinking about a few things in tandem ...

Although the state has plenty of doctors, it doesn't have enough who actually see patients - a situation that creates "a silent and growing crisis," the head of the state medical society said yesterday.

MedChi and the Maryland Hospital Association released a study yesterday showing that the state has 179 doctors delivering care for every 100,000 residents. That is 16 percent below the national average of 212.

Full article at:
http://www.baltimoresun.com/news/health/bal-te.bz.doctors08jan08,0,1498325.story

So in the face of an aging population (as the boomers age, retire and essentially become
"special needs" citizens - at least in the eyes of emergency management - we appear to
be facing a generalized shortage of doctors, albeit with regional hotspots of trouble (i.e. those states/regions showing smaller #s of doctors delivering care per 100,00 residents).

According to the article,

The greatest shortages in Maryland, according to the study, were found in rural areas and in certain specialties - primary care, emergency medicine, anesthesiology, hematology and oncology, thoracic and vascular surgery, psychiatry and dermatology.The study predicts a worsening shortage by 2015 as an aging population requires more care. At the same time, the physician force will experience more retirements. A quarter of the state's surgeons are 60 or older, the study found.

Hematology/oncology docs treat cancer patients, which will only grow in number as our populaiton ages given our current lifetime cancer risk in this country. Not good.
Worse is less primary care and emergency medicine docs, who will be crucial during surges in medical need, as will be experienced during some major public health issues of concern, like pandemic influenza and acts of bioterrorism.

Now couple this shortage with a general crisis in the public health work force, where the problem of being asked to do more with less has been growing steadily since 2001, despite larger amounts of cash coming into the national public health system from federal preparedness grants given to states.

Now in Maryland, this was studied in greater detail by Dr. Tom Burke's group at the Johns Hopkins Bloomberg School of Public Health (my alma mater and former employer).
See http://www.jhsph.edu/ecehp/Profile%20Report%20Page.html for their
"Profile of Maryland Environmental Health Practice." The report really is a first-of-a-kind
in terms of a comprehensive review of environmental health practice and found Maryland
"state’s environmental public health infrastructure is fragile, neglected, fragmented and under-funded."

So perhaps programs like the one in Joppatowne High School (see my blog posts from November for more links and info on this) are actually _needed_ in Maryland to compensate for our apparent lack of a homeland security and environmental public health
"pipeline" to ensure well-trained and prepared workers.