By Dr. Kevin Martin, Chief Medical Officer KVH
March 30 will mark the 182nd anniversary of the first use of anesthesia in surgery by Dr. Crawford Williamson Long, and so that is the day we celebrate National Doctors Day. At Kittitas Valley Healthcare, we take that as an opportunity to celebrate all of our providers and thank them for their commitment to our health and our community.
All the healing professions have an oath, pledge, or declaration that promises to respect and serve people. Mine, The Declaration of Geneva – 1994, started, “I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity.” Osteopathic physicians, physicians’ assistants, and nurse practitioners make similar promises.
Healing work, our service, takes many forms. It might be fixing a surgical problem, or diagnosing a medical one, or facilitating life’s inevitable transitions. It was the latter that drew me to family medicine, delivering babies and providing hospice care. Each of us finds the work that fulfills us, but that work is always about humanity.
When I started in private practice in 1998, probably 90% of my time at work was spent in the exam room with patients and families. I would come out of a room, spend a couple of minutes with a Dictaphone, and head to the next room. If I had someone in the hospital, I would make rounds at 7:00, at lunch, and at 5:30. I routinely saw 25-30 patients a day and was home for dinner or a kid’s game or recital. Primary care providers (PCPs) in a mature practice would have up to 3,000 people in their care. A workforce of 20 PCPs and a handful of surgeons, gynecologists, and other specialists could easily care for today’s population of Kittitas County.
That is not the work today. There is much more that we are expected to document at every visit. Some of the requirements come from the government and many more from insurers. Typing at a computer is slower than dictating. Studies and procedures need prior authorization from payers. Studies have shown that today’s primary care doctors spend 1-2 hours outside the exam room for every hour they spend in it, and the same is true to some extent across all specialties. High functioning primary care providers see 16-18 patients a day, frequently work into the night from home, and can only care for perhaps 1,500 people; 1,250 is probably a better number. The care that 20 PCPs could do before 2000 now needs at least 40, probably closer to 45.
Many providers are retiring earlier, especially since 2021, and we are not graduating new doctors fast enough to keep up. In 2023, the American Association of Medical Colleges (AAMC) reported that 83% of practicing physicians are over 40 and 23% are over 65. Nationally, some estimate we are short up to 30,000 providers, and AAMC expects that shortage to grow to as much as 139,000 by 2036. The shortage hit rural areas in the South and West hardest, and we feel it.
Every year at KVH, we put a table in the lobby for the month March with note cards and pens. If a provider has helped you, has impressed you, please share that. We share the cards with each provider. It’s a little thing, but it helps remind us why we do this work and for whom we do it. You can also thank your provider by visiting: https://qrco.de/drday24.
