Roanoke may be site of new medical school: The new school is needed to help alleviate a shortage of doctors in the Roanoke Valley.

BYLINE: Jeff Sturgeon, The Roanoke Times, Va.

Jan. 3--Plans for a medical school in Roanoke, which will bring Gov. Tim Kaine here today, could ease a doctor shortage that results in some people who need care being turned away.

One in five primary-care physicians employed by Carilion Health System recently has had to at least temporarily stop taking new patients, especially those on Medicare, to avoid being overwhelmed amid a worsening doctor shortage, Carilion said.

A medical school that turns out doctors locally will help Carilion come closer to meeting the demand for care, at a time when it is having a harder time hiring young doctors from outside the community. Not only is there a shortage of primary-care doctors -- those who can diagnose the stomach flu or high blood pressure -- but Carilion has a vision to employ or associate with a wide menu of specialists ranging from cancer experts to bone surgeons.

"The new facility will address future physician shortages in the area, boost the local economy, and attract technology firms and an educated work force," said a statement issued by Kaine's office Tuesday.

Kaine will join officials with Virginia Tech and Carilion Health System today to announce a medical school "in the Roanoke region," according to the governor's office. The event is scheduled for 3:30 p.m. at the Riverside Center office building at Jefferson Street near Reserve Avenue in Roanoke.

As first reported in The Roanoke Times on Nov. 30, health system and university officials have been quietly planning to open the state's fifth medical school and are leaning toward putting it in the Roanoke Valley. Officials have yet to release estimates for the school's enrollment, number of faculty to be hired, cost, opening date or legal structure.

Carilion has said it will expand physician training as part of its Carilion Clinic initiative. Virginia Tech sees medical education as working hand-in-glove with its ambition to expand research. But before late November, it wasn't publicly known that officials with either entity were thinking about a new medical school.

New medical schools respond to a need for more doctors. The Association of American Medical Colleges in Washington, D.C., citing the swelling ranks of senior citizens who tend to be frequent consumers of health care, has called for a 30 percent increase in medical school enrollment by 2015. Because there is limited capacity at the nation's 125 medical schools to expand, new schools are being planned.

Virginia has about 28,000 doctors, with 500 to 600 of them practicing in the Roanoke Valley. But the valley's medical community is graying. The average age of all doctors on the Carilion Medical Center medical staff is 49 and, in 2009, 44 percent will be older than 55, Carilion said. Some specialists are in short supply. For instance, an analysis last spring found that all six of the valley's dermatologists were booked solid for months.

While the worst aspects of a looming physician shortage are expected to occur in the future, some patients already are feeling the effects.

As of September, 41 of 203 Carilion primary care doctors were not accepting new patients because they were too busy to see more, said Hugh Thornhill, a Carilion executive vice president for primary care practices. Some 300,000 people see Carilion doctors for primary care, logging about 925,000 doctor visits a year. Carilion operates the largest primary care practice network in the region.

Practice closures, while sometimes temporary, occur when physicians reach or near their capacity to give prompt, competent care.

A typical doctor, with a patient load of 1,800 people, is supposed to try to see established patients within two days for an acute problem such as vomiting, earache or a high fever; within five working days for ongoing management of health issues; and within 15 working days for a yearly physical. If doctors didn't close their practices when capacity was reached, they would become overloaded and access goals wouldn't be met, Thornhill said. The problem has existed for about two years, he said.

Elderly patients on Medicare find it harder to locate care in a tight market for primary physician services. An elderly patient goes to the doctor an average of five or six visits yearly. Thornhill said doctors who are close to reaching capacity might turn down a would-be new patient from that demographic group while taking on someone who is young and healthy and might go to the doctor once every year or two.

Hiring more doctors is an obvious solution, but Carilion must compete against other community health systems and practices for newly minted physicians. The typical candidate who considers a post with Carilion ultimately explores five to seven job opportunities before making a decision, Thornhill said.

If a medical school existed in Roanoke, a natural steppingstone would be for newly trained doctors to undergo postgraduate medical education, known as residency, with Carilion. That, in turn, could expand the supply of doctors in the region because doctors tend to practice in the community in which they complete residency, Thornhill said.

Just three years ago, the Edward Via Virginia College of Osteopathic Medicine opened in Blacksburg to strong demand from would-be doctors. The private college, founded to add family doctors in rural communities throughout the central Appalachians, last year drew 2,300 applications for 159 seats.

The physician shortage is also affecting North Carolina, where researchers concluded that the state's rapidly growing population and rising number of older residents will overburden the state's physicians if steps aren't taken to increase their numbers, according to a Dec. 22 story in the Raleigh News & Observer.

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