"I was very nervous about having to make that trip. I was worried about the jolting of the car. Definitely scared," says Chorzempa.
There was no way around it. Chorzempa couldn't deliver in the rural town she lives. There's no hospital with a maternity ward and not a single obstetrician for miles.
"It's a scary thought, not being close to a hospital and not having a doctor close."
But it's a thought Americans everywhere may have to get used to. Rising malpractice premiums, falling reimbursement and fears of being sued have forced obstetricians in some states into early retirement. It's creating a shortage in this specialty. In fact, 1,500 counties in the United States do not even have a single obstetrician.
Patrick Vetere, M.D., used to deliver babies. He now just practices gynecology.
"We have a medical liability system that's out of control. I felt not doing obstetrics, you could avoid quite a bit of that," Dr. Vetere, who practices in Garden City, N.Y., says.
But the shortage won't be limited to obstetricians. As 79 million baby boomers reach old age, experts predict we'll be short 200,000 physicians by the year 2020.
"Any disaster that calls forth the need for lots of doctors, they just aren't there," says Richard Cooper, M.D., with the Council of Physician and Nurse Supply and the University of Pennsylvania. That's because in the mid 90s, congress capped spending on medical residencies, the key on-the-job training program that all doctors need before they are allowed to practice. And only three medical schools have opened since 1982. Now, older physicians are retiring in large numbers, and younger doctors, many of them women with children, are demanding shorter workweeks.
"Even this newer generation of men, male physicians tend to want to be more involved with their families, tend to want to work fewer nights, fewer weekends," says Dr. Cooper.
The trend is causing emergency rooms across the country to scramble to get doctors to cover shifts, especially overnight. In geriatrics, the shortage is also acute. There are 7,600 in practice, while some estimate need 20,000 to meet our need. That's forcing seniors, like Henry Fischel, to live with his pain.
"It took me over three years to find the medical help that I needed," says Fischel.
"It's a very significant problem, especially because you have an enormous aging population," says Beatriz Korc-Grodzicki, M.D., Ph.D., an assistant professor of geriatric medicine at Mount Sinai School of Medicine in New York.
Other specialties that will suffer: Oncology -- the demand is projected to increase by 48 percent because of more cancer survivors, but supply is only projected to increase by 14 percent. Experts predict a 20-percent decrease in the number of cardiologists by 2020. And one report suggests the United States should have more than 30,000 child psychiatrists, but there are less than 7,000 in practice right now.
For patients like Chorzempa, help was on the other side of the mountain. At eight months pregnant, she moved to a friend's basement to be closer to her doctor and avoid that treacherous ride. She's now got a healthy baby girl.
Experts say we'll need to train 10,000 more physicians each year to meet our needs. Medical schools are considering slightly increasing enrollment, but there's no quick fix. It takes about seven years to train new doctors. And congress has not yet approved enough spending to add to the number of residency positions.
This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
For more information, please contact:
Richard A. Cooper, M.D.
Professor of Medicine and Senior Fellow
Leonard Davis Institute of Health Economics
University of Pennsylvania
3641 Locust Walk
Philadelphia, PA 19104