Radiologist puts VA crisis into economic context

Radiologist Eric Schnipper, MD, provided an economic perspective on the Veteran’s Administration hospital crisis for CNBC’s “Street Signs” segment last week.

The radiologist attributed the service issues to two basic problems: A supply-and-demand imbalance between usage and physician staffing, and the V.A.’s difficulty in attracting physicians due to low salaries.

Schnipper, partner and political liaison at NRAD Medical Associates, Garden City, NY, cited increases in the number of new veterans entering the system from the wars in Afghanistan and Iraq and the aging of veterans from previous conflicts, layered over the failure to add enough internists and specialists to accommodate the increased demand.

“There is a four to five times ratio between patient increase and physician increase,” he said.

It’s not for the lack of trying on the part of the V.A., he noteds. Medical school graduates are bombarded with offers from the V.A., but few respond, largely because the compensation is so low.

“Every state is forecasting a shortage of physicians now and part of the reason is that medical schools have not increased the number of residencies going back 30 years,” he said. “When you don’t compensate people fairly, there’s a problem.”

Schnipper referenced the medical malpractice crisis in addressing projected physician shortages across the broader U.S. health-care system.

“There are pockets in this country—and some of them are encroaching on metropolitan areas—where you cannot find a pediatric neurosurgeon,” he said. “You cannot find an obstetrician who will deliver babies, and the reason why is that malpractice rates are on the order of $300,000 a year…. And the rates are going up and up even as physician reimbursement rates are declining.”