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Feb 18, 2009 9:28 AMPublication: The Southampton Press

East End community struggling to recruit and retain doctors

Feb 18, 2009 9:28 AM

Long Island is facing a shortage of doctors that is putting access to health care at risk, according to a report the Healthcare Association of New York State released last month, which says hospitals are being forced to reduce or eliminate services.

A joint release from HANYS and the Nassau-Suffolk Hospital Council characterized the physician supply on Long Island as “critically low,” warning “the crisis will only worsen in the coming years, as Long Island’s aging physician workforce begins to retire.”

Hospitals on the East End of Long Island are looking to stem the tide by finding new ways to attract young doctors to the area.

The HANYS physician workforce survey says the state had a net gain of 300 doctors outside of New York City in 2007, with half of the increase in Nassau and Suffolk counties. That still leaves a dearth of 322 physicians on Long Island, according to HANYS.

Officials at the two community hospitals that serve the South Fork of Long Island—Southampton Hospital in Southampton Village and Peconic Bay Medical Center in Riverhead—said that this region is not quite in a crisis, but is facing obstacles.

“We’re close to the edge of being critical,” Southampton Hospital President and Chief Executive Robert Chaloner said recently.

“Actually, in the last couple years we’ve recruited more than we’ve lost,” Mr. Chaloner said. In the areas of primary care, such as internal medicine, the hospital has done very well, he said, “but it’s taken a lot of time, money and effort to make that happen.”

There is still a relative shortage of primary care physicians though, said Dr. Fred Weinbaum, chief medical officer of Southampton Hospital. And the further east a medical practice is located, the more difficult it is attract a new recruit, he said. For example, an internal medicine doctor in East Hampton recently left his practice for a job at the hospital and the practice has not been able to replace him as of yet, even with the hospital’s help recruiting.

Dr. Weinbaum pointed out that a few doctors who practice on the South Fork commute from points west, and he said that might become more common since Suffolk County added an eastbound lane to County Road 39 last year.

“The commute into Southampton is bearable now that they fixed the highway,” he said.

Yet Long Island has extremely high malpractice insurance rates compared to rates in other states, and on the East End the cost of entry—buying a home—is also discouraging to young doctors coming out of medical school with a lot of debt, Mr. Chaloner said. Most applicants love Southampton when they come for an interview, he said. “Then when they see the cost of a house, it scares them away.”

Coupled with high prices and high expenses are the low reimbursement rates health insurance companies pay doctors on the South Fork, Dr. Weinbaum said.

Health insurance has also changed the secession of medical practices from retiring doctors to young ones, according to Dr. Weinbaum. “Practices are not as easily transferred from one person to another,” he said.

And patients who draw health benefits from their employers change doctors based on their insurance providers, so patient loyalty is not as prevalent as it was in the past.

On Their Own

When medical practices cannot find doctors on their own, putting a region at risk of inadequate health care, the responsibility falls on the shoulders of the hospitals alone.

“The government really doesn’t play any role in it, unfortunately,” Mr. Chaloner said. “It really is left to the local community hospitals.”

For its part, Mr. Chaloner said, Southampton Hospital has hired professional recruiters and offered housing assistance.

“It’s probably not going to get better anytime soon,” Dr. Weinbaum said. The state of the economy may have softened the rental market, making the area more affordable, but it has also put a strain on the donors who have supported physician recruitment ventures, he noted.

Part of the reason New York City does not have similar problems is that so many medical schools are located there, Mr. Chaloner said. Medical students “often tend to stay wherever they did their medical training and their residency,” he said.

The hospital’s recruitment plan has been in place since it surveyed area doctors in 2006 to determine how many doctors there are in different fields, who is going to be retiring soon and where there are shortages.

“For every problem, you have to come up with creative solutions,” said Peconic Bay Medical Center President Andrew Mitchell.

One method for recruiting and retaining doctors that Peconic Bay and Southampton have both adopted is to incorporate medical practices under “friendly physician corporations.” Under the corporations, the practices benefit from economies of scale and the hospitals provide management, so doctors do not have to worry about the business aspects of practicing medicine.

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What a loss for the east end, Dr. Diaz is an amazing doctor!! It's a shame that more cant be done to keep the good ones here, next my family will be losing our pediatrician.. Dr Garabedian is leaving too! :(

By leavingli66 (8), southampton on Feb 16, 09 4:55 PM
It is extremely sad to hear of another long time, loyal to our community doctor leaving! After hearing Dr. Garabedian was leaving, I was so sad for the long time connection I have had with him for over 14years!!!!! Our area is in need of an overhaul otherwise we will be looking for new doctors in each and every field!!!!!!
By tmcculley (4), Water Mill on Feb 16, 09 5:36 PM
Just wondering, what is the hospital doing to try to retain the doctors who have been here for so long, the article spoke mostly of trying to recruit new ones. Too bad they arent working harder to keep the ones we have !!!
By leavingli66 (8), southampton on Feb 16, 09 6:18 PM
This is such sad news, we live in one of the most beautiful areas in our country but are loosing some of the best Doctors we have ever had. Dr Diaz helped to be a part of bringing my three children into the world and Dr Garabedian has been such a part of keeping them healthy and strong They both will be missed so much, too sad it has to happen. kkrzenski
By krenski (2), southampton on Feb 16, 09 6:49 PM
It is not everyday that you are able to find a doctor for yourself or your child that has a great bed side manner, a professional yet personable personality, compassion, as well as intellect to put your mind at ease. Dr. Diaz delivered my son almost 14 years ago and if it wasn't for his quick response to my complicated pregnancy, I probably would have lost my son.He truly is an amazing doctor that has been an asset to Southampton and we will be at a great loss without him. Dr. Garabedian has been ...more
By Tmclaren (1), southampton on Feb 16, 09 6:52 PM
The housing costs and the malpractice insurance has always been a problem here. Ten years ago there was another round of doctors that moved because they couldn't afford to live here. It is a wonderful place to live but it has become so over priced that doctors and other professionals can no longer afford to live here.. What is that saying about the community? I have heard many times what a small, limited hospital we have and that they will go to the city... There are many emergency occasions ...more
By localgirl (17), southampton on Feb 16, 09 7:05 PM
Leaving makes a very good point, a plan needs to be developed to retain the great Doctors that we already have here. I agree that recruiting new doctors is always necessary but so is loyalty for the Physcians (i.e. Dr. Diaz and Dr Garabedian)that have given tireless hours to bring many children into this world and another to be on call to make sure those same babies are healthy. We see them as Doctors in their offices but if you notice you'll also see them living in our community, they have families ...more
By wondering (63), Southampton on Feb 16, 09 8:01 PM
I have worked in the medical field clinically or clerically for 21 years. I can't tell you how disheartening it is to me to see a doctor as capable, compassionate and well liked as doctor Mark Garabedian have to leave this area. I have had the pleasure of working with him for 9 years and can tell you that it is a HUGE loss to the community of Eastern Long Island to lose him.
It is few and far between when you encounter a doctor who has the experience, knowledge and concern to care for patients ...more
By Carole (2), Port Jefferson on Feb 16, 09 8:31 PM
Where is Dr. Garabedian going?
By lolamom (3), Speonk on Feb 16, 09 9:43 PM
Shortly after we had our daughter, who was delivered by Dr. Diaz, we heard he might be leaving the East End. What a loss. He was an excellent physician throughout our pregnancy. Thanks to Dr. Diaz and the labor and delivery nurses at Southampton Hospital our daughter's birth was without complication and a pretty wonderful experience.
By Ella'sMom (1), East Hampton on Feb 17, 09 9:41 AM
Re: 27east - East End hospitals struggling to recruit and retain doctors

"It is such a loss to loose a doctor like Mark. He has a way with children-he reaches them with humor and love-and the children are drawn to him.
His bedside manner is not only a comfort to his little patients, but to parents as well. Outside of work, I know from personal experience, he has volunteered many hours of his time coaching a little league baseball team. Once again, all done with humor and love. It is ...more
By leavingli66 (8), southampton on Feb 17, 09 9:53 AM
Many of these doctors, including my daughter's Southampton pediatrician now, don't accept all health insurers. My insurance is pretty mainstream and a lot of regular working people here have it, yet it's not accepted everywhere in the Hamptons (but is everywhere else on the Island). Perhaps these doctors preferred New Yorkers with cash or premium private plans? In any case, this taught us to just go to Riverhead and elsewhere for our medical coverage. Now, with the recession and fewer rich people ...more
By Mr Suffolk (113), Twin Forks on Feb 17, 09 10:05 AM
People have to start realizing that the insurance companies can even control what medication a doctor can or cannot prescribe for their patients. Several larger "mainstream" insurances do not even reimburse the physicians what state aide insurances reimburse. This has nothing to do with catering to the "rich" instead of the "poor"..this has to do with insurance companies not reimbursing physicians so they can afford to practice. It is a VERY big problem.
By Carole (2), Port Jefferson on Feb 17, 09 11:30 AM
Malpractrice insurance costs for an Obstetrics specialist on the East End of Long Island is between $175,000 and $225,000 per year. Reimbursement rate for the delivery of a healthy baby is $2000. So a doctor needs to deliver 100 babies just to break even on the insurance. Not a great business.
By davidf (325), hampton bays on Feb 17, 09 2:06 PM
Davidf...that is an incredible number. No wonder why we are loosing talented doctors out here. I hope that we as a people start to wise up about the problems with the insurance companies and our health care system. The Insurance companies and HMO’s have too much say over our health choices and they control the monies. The system is not working well. As for this situation, I hope that some how Dr’s Diaz and Garabedian are able to stay on the South Fork.
By SHNative (554), Southampton on Feb 17, 09 5:13 PM
Unfortunately Mr Suffolk, people taking your 10.00 copay with another 20.00 coming from your mainstream ins carrier to Riverheard isn't any doctors concern. Thats not even enough to pay the medical assistant to spend endless amounts of time on the phone trying to preapprove treatment the doctor orders. There is so much that offices have to deal with that patients arent even aware of. No one knows until something doesnt go your way...like dropping your insurance.
By squeaky (291), hampton bays on Feb 17, 09 7:08 PM
Malpractice insurance rates are high for Obstetrics because birth trauma lawsuits result in immense monetary payments from insurance companies to lawyers and the surviving members of the lawsuits. Insurance companies aren't in the business of losing money (unless they're AIG) so charge high rates. How about we limit the amount of money that a lawyer can make from a medical malpractice lawsuit, the same way that a doctor has the amount of money they can make from delivering babies limited? Let's ...more
By davidf (325), hampton bays on Feb 17, 09 9:54 PM
Davidf, that is right insurance companies are in the business of making money. That is one of the reasons why our health care system is not working well. Doctors, nurses, specialists, and hospitals should be making money, not CEO’s of insurance companies. Because of this we are loosing two great doctors, Garabedian and Diaz. I wonder what we can do right now to keep them here for the children of the East End.
By SHNative (554), Southampton on Feb 18, 09 7:21 PM
I have far more problems with the staff at doctor's offices here on the East End than with lack of drs. I haven't met a more incompetent group of office staffers elsewhere. I am a retired health care administrator with 25 years of experience in the tri-state area, including at inner city ERs, where you can work with some real lulus. The wait time for appointments is ridiculous and when I finally get to the doctor's office a month after making the appt, I am told I do not have an appointment (had ...more
By btdt (449), water mill on Feb 28, 09 4:18 AM