The governor, state lawmakers and a trade association for hospitals and healthcare systems say finding legislative solutions to Delaware’s primary care physician shortage needs to be a priority this year.

The answers are complicated, including the potential creation of a medical school and efforts to raise insurance reimbursement rates for physicians. There are also the intertwined challenges of creating quality schools and a wide range of housing options and a quality of life that would attract healthcare providers and support staff.

“Addressing the healthcare workforce shortage is a top priority for Gov. Meyer,” said Mila A. Myles, director of communications for Gov. Matt Meyer.

“That means making sure we’re doing everything possible to recruit, train and retain not just doctors but all medical providers,” Myles said. “The governor is looking into how a new medical school could be part of this solution and is considering other various strategies to improve healthcare access in Delaware. Gov. Meyer will continue to work with folks in the medical, academic and nonprofit communities to tackle this issue head-on and ensure Delawareans are getting the care they need."

“Having a medical school would help ameliorate the problem of attracting medical school grads,” said Rep. Claire Snyder-Hall, D-Rehoboth Beach. “It’s something that is moving forward. It will take several years.”

She said the governor and General Assembly backed the concept of a medical school last year.

Sen. Russell Huxtable, D-Lewes, said recently he is looking forward to the beginning of the legislative session to see various bills drafted to help address the physician shortage. Huxtable said he supports the creation of a medical college.

Snyder-Hall said she expects the state to consider removing barriers for healthcare providers establishing themselves in Delaware. That includes making it easier to transfer medical credentials from other states and expedited background checks for home healthcare providers. Access to telehealth has also been expanded to help address the need, she said.

“The need for healthcare providers was the No. 1 concern I heard when I knocked on doors,” she said of her campaigns, dating back to a 2014 run for state Senate.

“It is becoming more of an issue because we have more people moving here,” Snyder-Hall said, noting many are retirees who have increased need for medical care.

Sussex County’s population has been increasing faster than the state’s other two counties in recent years.

U.S. Sen. Lisa Blunt Rochester has been working to address the shortage of healthcare professionals nationwide, particularly nurses.

“Workforce shortages across the country, especially in Delaware, are impossible to ignore because of the impact it has on our day-to-day lives,” Blunt Rochester said. “From public safety to healthcare, communities in our state are at risk of not having their basic needs met. In the House, I was glad to introduce legislation to combat shortages in our healthcare, including the National Nursing Workforce Center Act, and I am looking forward to reintroducing and fighting for similar legislation in the Senate.”

She led the 2022 passage of legislation that allowed hospital-based nursing programs to retain federal funds, including $1 million for the Margaret H. Rollins School of Nursing at Beebe Healthcare in Lewes.

The Sussex Economic Development Action Committee commissioned a $100,000 study, completed a year ago, to determine the feasibility of establishing a medical school in Sussex County. It found a project affiliated with an existing med school would be feasible and urged immediate action on the project.

No healthcare organization in the county has the clinical capacity to support a medical school by itself, but pooling resources could make it a reality, the study found. 

The need for action was highlighted last month when a state-by-state ranking released by Becker’s Hospital Review found Delaware last in the nation in filling its residents’ need for primary care physicians.

The state meets only 14.85% of the need. Sussex County alone requires another 21 doctors to fill the community’s need, according to figures compiled Dec. 31 by the U.S. Health Resources and Services Administration that were used in Becker’s ranking.

The Delaware Healthcare Association weighed in Feb. 27 on the issue, releasing its state priorities for the year, which include: 

• Create a healthcare workforce shortage scholarship program and new incentives for clinical preceptors

• Advocate for prior authorization reform legislation along with the Medical Society of Delaware to streamline and improve care for patients and relieve providers of excessive paperwork
• Advocate for adequate reimbursement for primary care, behavioral health, and other preventative care that improves community health and reduces utilization
• Advocate for health insurance coverage for the uninsured, underinsured and most vulnerable, including preventative coverage for prenatal care and dialysis care

William Albanese, CEO of healthcare provider Atracare, blames much of the physician shortage on reimbursement rates from insurance companies, which are 30% to 40% lower than surrounding states. This discourages physicians from working in the area and prompts some to become concierge doctors, charging an annual fee on top of fees for specific services provided.

Healthcare providers have been attracting more physicians through expanded residency programs, bringing in foreign providers through a visa program and financial incentives. Technology like telemedicine and time-saving computer medical records systems has made the work of providers more efficient and saved them time that they can devote to seeing patients.

Dr. Paul R. Sierzenski, senior vice president and chief physician executive for Beebe Healthcare, recently said Beebe established its own residency program two years ago to train physicians. Beebe is nearing completion of a facility in Long Neck that will accommodate the growing family residency program, which will be expanded to include other disciplines. It is scheduled to open this summer.

The Delaware Healthcare Association noted that anticipated federal aid cuts and a growing and aging population in the state are placing pressure on the healthcare system. 

“Delaware’s rapidly aging and growing population – sixth oldest and eighth fastest growing – increases demands on the state’s healthcare infrastructure while at the same time, Delaware faces a healthcare workforce shortage,” according to an association news release.

“Delaware also has higher rates of chronic disease and health conditions than other states that contribute to higher healthcare costs: Delaware has the eighth highest rates of adult obesity, the ninth highest rates of diabetes, and the 15th highest cancer incidence,” according to the release.

Brian Frazee, president and CEO of the Delaware Healthcare Association, said March 6 that action is also needed at the federal levels.

The association last week issued its very first federal advocacy agenda. Among its recommendations were prevention of cuts to Medicare, Medicaid and Health Insurance Marketplace; and make permanent telehealth flexibilities and the hospital at home program, which both expire in March.