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Editorial: Gov. should take lead on access to health care

Is there a doctor in the house? Or at least in the office?

Maybe, but you might have to wait weeks – or longer – to see him or her.

That message came through loud and clear in Journal investigative reporter Colleen Heild’s “Feeling the Pain” series. Over two weekends she detailed the shortage of physicians in New Mexico and its impact on people seeking medical help. Journal readers chimed in with their own first-person accounts of their frustrations and long waits to see a doctor for ailments ranging from cancer to gastrointestinal bleeding to simply seeing a primary care doctor.

One study ranks us 48th in the nation for physician access, and some specialties, neurology for example, are in short supply. The shortage is particularly acute in rural New Mexico.

New Mexico is predicted to have one of the oldest populations in the nation by 2030, and older people typically have more medical needs than younger ones. Currently, we have one of the oldest physician forces in the U.S. with a large number planning to retire in the next few years.

So the system might not be on life support – yet – but Gov. Michelle Lujan Grisham isn’t far off the mark when she says, “We’re all having trouble. The system is broken.”

And she’s right on target when she says,”We have to do everything in our power” to fix it.

In fairness, we might be ranked among the worst, but this is a national problem.

And there are some things New Mexico can do to bolster the ranks of doctors in the Land of Enchantment, along with improving access in general with nurse practitioners, physician assistants and specially trained pharmacists.

There also are some things we could do to make it worse, and we pursue those at our peril.

On the positive side of the ledger:

• Increase Medicaid reimbursement rates for medical providers, who have seen cuts in payments due to state budget problems. Lujan Grisham says, “We can’t ask physicians and other practitioners to stay or come to New Mexico if they lose money in the practice.” She’s right.

• Leverage more Medicaid dollars to fund additional graduate medical residency slots. The governor argues if the state can pay for residency training, combined with loan repayment of forgiveness, “they’ll stay here.”

• “Train and recruit,” says Jerry Harrison, executive director of New Mexico Health Resources, which recruits health professionals. “Unfortunately we train a lot of people for export.”

Dr. Steve Jenkusky, a psychiatrist and chairman of the New Mexico Medical Board, said the state could launch a New Mexico True-like advertising campaign aimed at physician recruiting. He recalled that what lured him to New Mexico for his residency – he was living in Illinois – was a vacation guide included along with his application packet from the University of New Mexico. Why not use our strengths?

• Grow the labor pool. Various legislative measures propose funding for residency slots, tax credits for providers who train doctors, nursing or pharmacy students, and an “Osteopathic Physician Excellence Fund” for educational loan repayments.

These proposals offer sound prescriptions for improvement; a smart start would be for lawmakers to allocate the $18 million needed to rebuild New Mexico’s provider network, which with the federal match would mean a $80 million boost.

On the “do harm” side of the ledger:

• House Democrats’ HB 6 boosts state income tax to 6.5 percent for top earners, putting us out of synch with neighboring states and giving Texas – with no state income tax – an even bigger recruiting tool in a war it is already winning.

• Other legislation, HB 629, would raise the cap on malpractice awards from $600,000 to $2 million in a state already considered friendlier to trial lawyers than to doctors.

Jeff Bourgeois, CEO at San Juan Regional Medical Center in Farmington, said it’s tougher to recruit if doctors “can’t earn an income commensurate with other states” or they have to “pay more in taxes or risk practicing in an unfriendly litigious environment.”

The message both these measures send: Hey doc, look elsewhere.

Other, more global kinds of problems include the state’s reputation as a high-crime haven, lots of poverty and less than stellar public schools. None of these makes recruiting easy.

At the end of the day, this is a problem so big it simply can’t be solved piecemeal. But there seems to be a growing consensus New Mexico needs to take it on. And only one person has the power of the bully pulpit and ability to convene the best minds and experience and get something done. That’s the governor.

Lujan Grisham, who has important personal and professional experience with the health care system, can and should bring together health leaders, educators and others to do a thorough exam of this needy patient and come up with an overarching and holistic prescription.

Because New Mexico can’t hope to prosper and move from its bottom-tier rankings in so many categories if we can’t get health care on its feet and moving toward recovery.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.