Thread: Kansas City Missouri struggles to keep,recruit doctors

Posted on Sun, Mar. 07, 2004

Kansas City struggles to keep, recruit doctors

Shortage can mean a long wait between visits

By ALAN BAVLEY

The Kansas City Star


Lung specialist Mary Wurtz sees 30 or more patients a day — young adults with asthma, smokers with lung cancer and the elderly suffering emphysema.

With hospital rounds and a growing number of office visits, her work days can stretch from 10 to 12 hours, six days a week.

For more than a year, Wurtz has tried to attract another doctor to her four-member practice in Independence. She is offering about $120,000 a year, but beginning specialists can command several times higher in other parts of the country.

“You can't begin to compete — unless none of us were to take a salary at all,” she said.

As Wurtz has discovered, it's getting hard to find doctors who want to come to the Kansas City area.

Low insurance reimbursement rates and high malpractice premiums, compounded by a developing national physician shortage, have created the toughest recruitment market here in years, experts said.

The Kansas City area has as many as 100 physician openings, two or three times the usual number.

The shortage means doctors burn out on long workdays. Patients' health deteriorates as waits for appointments drag out for weeks or months.

More ominously, the difficulty in recruiting doctors to Kansas City led to the elimination of emergency neurosurgery at Independence Regional Health Center and St. Joseph Health Center. Those hospitals could not find new neurosurgeons to replace ones who left.

“It's so hard to recruit unless it's a perfect position,” said Julie Sherriff, a Prairie Village-based physician recruiter with 20 years of experience.

Cardiologists, orthopedic surgeons, dermatologists, neurosurgeons and ear, nose and throat specialists are all in demand — and difficult to get.

Making matters worse, baby-boomer MDs are retiring just as the rest of their generation needs more health care.

“Getting critical access to specialty care could become a tremendous problem in the near future,” warned Charles Rhoades, a Kansas City area orthopedic surgeon.

Rhoades lost several potential recruits for his practice because they found better-paying jobs elsewhere.

Other areas, such as Seattle, Detroit, Chicago, Maine, Florida, Nevada and parts of California, also are having a tough time recruiting, Sherriff said.

But the metropolitan area is at a competitive disadvantage, even with smaller, nearby cities such as Springfield and Topeka.

“Just picture a young physician coming out of school with heavy debt,” said Independence cardiologist ***** Akin. “They look at the reimbursement rates and the malpractice premiums here and go elsewhere.”

Akin said cardiologists typically make $250,000 to $500,000 in the Kansas City area.

Several times a week, however, he gets solicitations touting jobs with an “attractive Southern community” or “universities” or a “new heart program” and substantially higher incomes.

“I could go somewhere else and make more money, significantly more money, guaranteed,” he said.

Pay lags other areas

At least two independent reports have concluded that Kansas City area physicians are poorly paid compared with their colleagues in other cities.

An assessment of local health services released in 2000 by the United Auto Workers and Ford Motor Co. found that insurance companies paid doctors here 11 percent less overall than the national average.

Some services, such as office visits, were reimbursed at about half the rates paid elsewhere.

A study in 2001 commissioned by St. Luke's Hospital looked at physician reimbursements closer to Kansas City. It found that health maintenance organizations in Springfield paid doctors 28 percent more and that preferred provider organizations in Topeka and Wichita paid 21 percent more.

Nothing has changed since to improve the situation for local doctors; reimbursements are 20 percent to 40 percent higher in other parts of the Midwest, said Kenneth Washington, vice president of HCA Midwest, the largest hospital group in the area.

“There is absolutely no question in my mind that rates are depressed here,” he said. “Yet we experience the same cost increases, inflation as anywhere else.”

One reason for the low pay, Washington said, is that most Kansas City doctors practice in small groups. In states such as Minnesota, Wisconsin and Illinois, it is not uncommon for group practices to have dozens or even a hundred or more physicians.

“They've got leverage; they've got clout,” Washington said. “We don't have that critical mass. No one can say to (an insurance company), ‘I am indispensable to your plan.' ”

The concentration of Kansas City area hospitals in just a few large systems also weakens doctors' bargaining power, said Mike Reardon, president of Kansas City Physicians Organization, a doctors' advocacy group.

“The (insurance) carriers would first

if a democrat gets elected , it will just get worse. go to www.protectourpatients.org and see how each state stacks up on tort reform, and where teh docs are leaving because they cant afford to work there!

Originally Posted by jim

if a democrat gets elected , it will just get worse. go to www.protectourpatients.org and see how each state stacks up on tort reform, and where teh docs are leaving because they cant afford to work there!

This is what I have said for a long time. Instead, the imbesile Bush-haters can only go on ranting about all the "lost civil liberties", how many trillion lives were lost in Iraq and how much the jury system is "protecting the atients"

Most people that are voting democrat this time doesn't even KNOW anything about politics, but simply have been deluded into thinking that the 2.5 mill outsourced jobs in manufacturing would not have been outsurced under a rule of a party with the mislabelling name "democrats".. And the same democrats opened this game when Clinton praised the Chinese government for their "progresses" as he went and held a speech at Tianamen.

Democrats are hyppocriticals that are experts in deceiving people about realities while managing to supply their fans (the lawyer lobby) more than anything else..

Tax cuts? Lawyers don't need that, because they will always find all loopholes anyways, better then to tax everybody to death and let their special-interest groups (REAL special interests) drink from all the cracks others can't see!!

If it is indeed true that there is a doctor shortage, then I guess that means those of us headed to medical school can expect to have a job and decent level of job security, which frankly is very important in this day and age of the dreaded globalization.

"imbesile Bush-haters can only go on ranting about all the "lost civil liberties", how many trillion lives were lost in Iraq "

i hope his "strategery" worls in november. ironically mostly white people who have never had the pleasure of experiencing civil injustice smurk at this gestapo like bill that is being marked for permanent law. i look as white as the next guy so its usually not until a traffic cop gets my license that the attitude changes i can only imagine what being pulled over for DWB (driving while black) would be like.

to dismiss the 500 soldiers who have needlessly lost their lives is an insult to me and every other person who has ever been proud enough to lace up the boots and write dear mom letters making that "trillion" statement only exemplefies that youth in america have no concept for the value of human life. president bush inherited the disasters of clinton (nafta, etc) but has managed to loose another 2.4 million jobs on top of that. but its all good because the people he gives tax cuts to, rich people (i got $58..hehe), have helped raise over 200 million bucks to make sure their door to the whitehouse doesn't close. this administration has created terrorist where there weren't any, did you guys see anti-american protests in badhdad with fists in the air and the cliche flag burning?it has has made the world that already sees us in bad light hate us more than ever! they send us conflicting messages about what we should do: should we live our lives without fear and continue our every day errands or should we re-elect them to keep protecting us from the imminent dangers? all while at the same time they have allowed big corporations to reverse decades of hard work by increasing carbon dioxide emissions over 20% and have scheduled coal plants to be built! what is this the 30's?

then there is there is the other side who is in the pockets of the teacher's union and trial lawyers and their stack of deeds. both sides are crooked and normally if i was in the majority lighter side of the nation i would go with bush but i can not in good concience vote for a man who has taken the very ideals of personal freedom and secular governemnt that this country was built on and torn them to shreds with the patriot act and proposing government intervention into who a church marries.

how many years from now will people start disappearing? how many years from now will we turn in our neighbors for flying different flags? it is funny to see people who have not studied history not realize that it does repeat itself time and time again, i remember reading diaries from german citizens during the late 1930's over these same topics...sure lets tighten up our freedom a bit to be more secure.....this "wolf cry" has been used before but it is the fact that we allow devil worshipers, the klu klux klan, and factions of the communist party here that has brought us einstein, apollo, hawkins and so much more in return! the world has called us basically uncooth, uneducated, red necks who have never seen the other side of our borders but have mistaken indifference for tolerance and freedom to think differently...

i for one don't care who sticks what where nor if my neighbor worships a finch named 'bubba'. i don't care what happens between jews and muslims around the world because at home i tolorate both and i don't care which religion says they are right because in the end it is only God's opinion that matters and it is neither my place nor anyone elses to determine what someone should beleive.

the day we as a nation begin to limit ourselves by restricting the very foundations we have built the greatest nation in history is the day we will see the fall of the "third roman empire".

i hope that you will apologize to the 500 mothers, wives, and the 112 children under 12 who now hold in their arms an American flag in place of a person for trivializing the sacrifice that they have made. what a ridiculous comment to make. you may be able to live with a more powerful governement, secret courts and juries but i for one think that it is the concept that the government can't have access to your personal life that sets us appart from 180 other countries on the world. why can't maccain run!!!!!!

.... ironically mostly white people who have never had the pleasure of experiencing civil injustice smurk at this gestapo like bill that is being marked for permanent law. i look as white as the next guy so its usually not until a traffic cop gets my license that the attitude changes i can only imagine what being pulled over for DWB (driving while black) would be like.
*****There is less racial profiling in 2004 than ten years earlier, so you trying to blame Bush-adminsitration for this is ridiculous. Also, comparing the patriot act to "Gestapo" just shows your complete lack of historical knowledge. But it is common for "liberals" to draw these vague cheap analogues even though they have nothing with the issue to do.



to dismiss the 500 soldiers who have needlessly lost their lives is an insult to me and every other person who has ever been proud enough to lace up the boots and write dear mom letters making that "trillion" statement only exemplefies that youth in america have no concept for the value of human life.
***I am not dismissing the death of the GI's, but rather I am sick&tired of "liberals" trying to overinflate everyhting. The same "liberals" never mention the 3000 killed in NY and they surely would not mention the other people killed all over the world by Al-Quaida. The facts are very simple, after 9/11 not a single terror attack have succeeded on Americal soil. Millions of people in Iraq and Afghanistan have been liberated from Islamic fascist dictatorships. The thing is;sometimes it is worth fighting for a cause and not choose the ways of Neville Chamberlain. You trying to portray me as a "cold insenitive whatever" is just another tactic from "liberals" in love with fake rhetorics and lies.



president bush inherited the disasters of clinton (nafta, etc) but has managed to loose another 2.4 million jobs on top of that.
***If you deduct the loss of manufacturing jobs, (which, as you rightly say, started with Clinton) and take into accord that 9/11 almost crippled the US economy, I think GWB deserves HUGE credit for his economic policy. Give me an alternative to NAFTA and I am glad to hear it. The European Union has a great protectionism policy in place, while at the same time having their own NAFTA. Can you explain me why their unemplyment average is twice of the US then>??




this administration has created terrorist where there weren't any
***Can you explain me how Bush "created" Bin LAden? Or is he not a terrorist in your eyes? Do you think the right thing to to with him is to approach him in a dialogue instead?? Maybe you should blame Clinotns 8 years for Bin-Laden striking WTC then, since the planning of this happened during HIS reign.. I am waiting for you explaining me this...


, did you guys see anti-american protests in badhdad with fists in the air and the cliche flag burning?
***Tha vast majority of Iraqis and Afghans ae VERY DELIGHTED we came and kicked their oppressors out for good. A few flag burners is not a big deal compared to liberating 20 mill+ people.

all while at the same time they have allowed big corporations to reverse decades of hard work by increasing carbon dioxide emissions over 20% and have scheduled coal plants to be built! what is this the 30's?
****I would like you to compare the pollution in the US with European countries as per population. I would also like you to comment on how to solve the energy dilemmas facing us. Are you willing to triple the gas prices like in Europa and signing a few symbolic treaties that give all dictatorships green lights since they are "developing" countries?? Also, could you explain me (again) how environmetally friendlier the Clinton Admin was here? again, democrats are all talk and no action. My beknown Bush was not in power when the Kyoto accord was ignored by the US, but liberls never ranted about that. Maybe you should go for Nader if you are concerned about these issues, or else you are simply a hyppocrat for talking about something you would not want done differently.


then there is there is the other side who is in the pockets of the teacher's union and trial lawyers and their stack of deeds. both sides are crooked and normally if i was in the majority lighter side of the nation i would go with bush but i can not in good concience vote for a man who has taken the very ideals of personal freedom and secular governemnt that this country was built on and torn them to shreds with the patriot act and proposing government intervention into who a church marries.
****That the country is "torn to shreds" with the patriot act is ridiculous statement that only a true visceral Bush-hater can say. When it comes to gay marriages, it is obvious that the majority of americans don't want that. Also, maybe you could enlighten me about Kerrys position here? Also "government intervention" into judges not upholding current law is nothing new. If you want gay marriages, then find a candidate that will advocate for a change in the law instead. Otherwise this is another contradictary statement with no backings.




how many years from now will people start disappearing? how many years from now will we turn in our neighbors for flying different flags? it is funny to see people who have not studied history not realize that it does repeat itself time and time again, i remember reading diaries from german citizens during the late 1930's over these same topics...sure lets tighten up our freedom a bit to be more secure.....this "wolf cry" has been used before but it is the fact that we allow devil worshipers, the klu klux klan, and factions of the communist party here that has brought us einstein, apollo, hawkins and so much more in return! the world has called us basically uncooth, uneducated, red necks who have never seen the other side of our borders but have mistaken indifference for tolerance and freedom to think differently...
***The same people that call us "rednecks", "uneducated" and "uncooth" are the same peple that would sell their soul for a green card, so their arguments are not worth a dime. Their mere desperate desire to get here at any cost just again confirm the great hyppocrisy here. Same goes for the muslims that have "lost their civil liberties". Two things here:

1.If it is so bad here, why bother going here at all?
2. If they still want to come here, then WHY complain about something they never had in their own country. (To my knowledge, no islamic countries are democratic).

You comparing the patriot act to Germany in the 1930's is nothing but a bunch of incoherent wabble. If this was a fact then, 99% of the world (having stricter security rules than us) are currenlty nazi-regimes. In the name of political correctness, Bush-Bashers LOVE to pull up a Nazi-germany implication, forgetting who toppled that regime in the first place.


i for one don't care who sticks what where nor if my neighbor worships a finch named 'bubba'.
***And neither do I. Go to any other country in the world and se if you can find an inch of more freedom than in the US.

i don't care what happens between jews and muslims around the world because at home i tolorate both and i don't care which religion says they are right because in the end it is only God's opinion that matters and it is neither my place nor anyone elses to determine what someone should beleive.
****To bad that OBL and his thugs DO care who you are. These people will not rest until thw whole world has converted to Islam and the last vestiges of the Nation of Israel is in the Meditterranean Sea. After Israel falls Europe is next. Funnliy enough, mullahs and clerics in Europe don't even HIDE the fact that they want all Europe to belong to Islam.
Taking away my right to express my religious freedom by not fighting AlQuaida does not give more religious freedom. I think we agree on the issue of religious freedom, but I just see that others won't.


the day we as a nation begin to limit ourselves by restricting the very foundations we have built the greatest nation in history is the day we will see the fall of the "third roman empire".
*****What was the "second roman empire"??


i hope that you will apologize to the 500 mothers, wives, and the 112 children under 12 who now hold in their arms an American flag in place of a person for trivializing the sacrifice that they have made. what a ridiculous comment to make.
****You trying to portray me as ignorant on this issue is simply ridiculous. People like you used to spit on my uncle as he came back form his TOD in Vietnam, calling him a "murder", "assassin" and the worse. If anyone have been known to show disrespect for our GI's throughout history, it is the leftist ranters that feel regimes like Pol Pot, Stalin and Cuba are our ideals. Everybody fighting in Iraq or Afghanistan makes life in the US safer day by day. As soon as OBL is captured along with the rest of his thugs, people like Howard Dean and other Bush-haters will probably be more concerned about their "lost civil liberties" than holding them accountable.


you may be able to live with a more powerful governement, secret courts and juries but i for one think that it is the concept that the government can't have access to your personal life that sets us appart from 180 other countries on the world. why can't maccain run!!!!!!
*****The average law-abiding legal resident/citizen in the US have NOTHING whatsoever to fear from the patriot act. If anyone wants to read my emails, tap my phone or for that sake search my house or car for sake of security, I say BE WELCOME. I have nothing to feel guilty about or to worry about and I think the FBI will conclude I live a life to boring for them to bother.

I bet you if there was proven to be an AlQuaida cell in the heart of DC, ACLU and the Bush-bashers would want the FBI to file a 15-page search warrant two weeks before the search in order to protect their "civil liberties".

It's a shame that some people think protecting terrorists out of fear of stepping on some innocents is the way to go to avoid another 9/11.

GO Bush (!!) and know that no presidential campaign ever have been lost to oppoents basing their campaign on visceral agitation.

i am not making direct comaprisons but only mirroring what the begining of the german experiment may have felt like. of course its not a direct event for event deal. and where do i blame the presidency for racial profiling? i said that unless you've experienced a violation of your civil liberties you can't really know what it feels like to loose them....i am by far from liberal i have been republican most of my life but i can't stand idly by when the core ideals of the nation are being raped. i personally don't care who looks at my email, tapes my phone calls etc, i just don't want a secret court doing it. yes it should be fast and the fbi cia etc should be able to look in on whomever they want but not without oversight...just waht is your defenition of gestapo if it isn't that? environemnt is a side issue for everyone but at least democrats pretend to care once in a while. if nader had some shot at winning he'd have my vote this year but there are more important things to do before worrying about the environment. as for gas prices yes they should go up, did you know gas companies get a subsidy of around 9 billion a year to keep the prices low? i always wondered why does it cost $5.00 per litre inb south america then i got my answer....and what i meant be creating terrorists is that this war thing has united those schmucks and they are now crawling from the woodwork and are now entirely focused in us. oh and its now 564 families not 500 that you trivialized, i mourn the people in the towers because they were senseless deaths then and there wasn't much we could do about it, the soldiers are senseless deaths now and all we have to do is load the c-5s and it would stop. simple solution, close the borders for five years until ins can put up a real system to track people in and out, and just deport everyone who isn't here legally instead of letting them claim asylum from here do it through the embassy in their respective pace.

see i have no political or religious affiliation, no direct ties to any of these thinsg so i see these things as they are...no emotion. so please turn black or hispanic take a ride down a backstreet in alabama and experience your civil liberties being abused before you applaud taking away mine.....all we need is common sense and right now neither side has any.

Originally Posted by rrod

...only mirroring what the begining of the german experiment may have felt like.

The foundations and ideological basiis of Gestapo were NOTHING like the patriot act. It is ridiculous even to mention a connection in any way here. In that case all the secret police in the world are "Gestapo", including Mossad in Israel, based on your extremely wide definition.

I would reccomend you to read about them in a good history 101 book or use this link :http://www.us-israel.org/jsource/Holocaust/Gestapo.html


.... and where do i blame the presidency for racial profiling?
***When you link this issue to the main topic (as we were discussing the elections you AERE linking it here. Just answer me a simple question. Are there MORE or LESS lracial profiling in 2004 than in 1994??

... i personally don't care who looks at my email, tapes my phone calls etc, i just don't want a secret court doing it. yes it should be fast and the fbi cia etc should be able to look in on whomever they want but not without oversight...
******Whether a "secret court" reads your email or a 2 month application, the outcome is the same for a law-abiding citizen, but in case of a terrorist, he gets a warning to call his ACLU-lawyers and hide everything.
THAT is the reason for a this.

just waht is your defenition of gestapo if it isn't that?
****I could tell you alot about Gestapo, but I think it holds to say that their agendas were totally different than the patriot act.

environemnt is a side issue for everyone but at least democrats pretend to care once in a while. if nader had some shot at winning he'd have my vote this year but there are more important things to do before worrying about the environment.
****SO in that case, the environment is an irrelevant issue then, isn't it??
Or if not, then whay mention it?? Now again. I would like you to tell me WHAT the "democrats" under Clinton and Gore did for the environment. If you don't know or don't care, then why take up the issue?

... what i meant be creating terrorists is that this war thing has united those schmucks and they are now crawling from the woodwork and are now entirely focused in us. oh and its now 564 families not 500 that you trivialized, i mourn the people in the towers because they were senseless deaths then and there wasn't much we could do about it,
******And did you listen to AlQuaidas warnings the last three years that more attacks will come? DO you know that Ansar-AL-Islam (in Iraq) is directly linked to Bin-Laden. Do you know that various other terrosists found safe haven in Iraq. Do you think Saddam would have hesitated selling mustard gas to them if he could?


the soldiers are senseless deaths now and all we have to do is load the c-5s and it would stop. simple solution, close the borders for five years until ins can put up a real system to track people in and out, and just deport everyone who isn't here legally instead of letting them claim asylum from here do it through the embassy in their respective pace.
***Haha, closing the US-Canadian and US-Mexican borders?? We will need more than 200000 trops for that. Also, show me the politician in the US besides the most alienated ones that would be willing to do so.
Agree this would be a good try, but realistic?? Not in this world. Also, it takes ONE terrorist with a suitcase of nuclear waste or a bin of Bacteria to damage us beyond repair. Pre-emtion is the only thng that has any chance here.

...so please turn black or hispanic take a ride down a backstreet in alabama and experience your civil liberties being abused before you applaud taking away mine.....all we need is common sense and right now neither side has any.

******If their civili liberties are being abused that is not in accord with the law and you know it. If an immigrant is detained due to having invalid papers, that is HIS problems and not his lack of "civil liberties".

I think there might be some agrement between us, but I feel lots of your perceptions of the "lost civil liberties" are visceral and not real.


btw, as a libertrarian I don't agree in sealing the borders either, but I DO believe in hitting back on anyone that wants to harm me, my wife or my people.

said it was illegal immigrants i said latino or black....example: i got pulled over when i was 23 i had a benz 500sl didn't do anything i was on the phone with my wife and he said i had a blown tail light but upon inspection it wasn't but i wasn't allowed to leave. instead i spent the next 4 hours in the back of his car in florida with the A/C shut off while they looked at my registration, called my insurance agent, called the leasing company, checked my background not just with broward county but with FDLE, and on top of that brought a drug sniffing K-9 and found nothing. in the end they opened the car door, undid the handcuffs, and took off. never said a word. it wasn't until later that i found that they couldn't search my car without permission that they didn't ask for nor could they pull me over without cause....that is one out of three that come to mind once with my daughter in my 65 mustang that didn't have seatbelts was the reason and the same thing, well it is a 1965 car they didn't require them then. three hours later i was on my way....

Originally Posted by rrod

said it was illegal immigrants i said latino or black....example: i got pulled over when i was 23 i had a benz 500sl didn't do anything i was on the phone with my wife and he said i had a blown tail light but upon inspection it wasn't but i wasn't allowed to leave. instead i spent the next 4 hours in the back of his car in florida with the A/C shut off while they looked at my registration, called my insurance agent, called the leasing company, checked my background not just with broward county but with FDLE, and on top of that brought a drug sniffing K-9 and found nothing. in the end they opened the car door, undid the handcuffs, and took off. never said a word. it wasn't until later that i found that they couldn't search my car without permission that they didn't ask for nor could they pull me over without cause....that is one out of three that come to mind once with my daughter in my 65 mustang that didn't have seatbelts was the reason and the same thing, well it is a 1965 car they didn't require them then. three hours later i was on my way....

Hi rrod, I think we are talking past each other. I am a strong proponent of legal protection and integrity of any citizen or legal resident no matter what. Being a libertarian at heart I do not see any infringements upon my private rights as justifiable. Unfortunately organizations like the ACLU have abused these things to front their own agendas and enrich themselves instead of helping people. ACLU and the feminists are the best power factions in the US to create conflicts and make victims out of everybody. We don't need these people to further ridicule the noble notion of civil liberties and equal rights.

If you had experienced this, I would reccomend you to file a discriminatory suit against he police officer as he obviously did something illegal. Such a suit might not have to long of a statute of limitations, but I am not sure about the laws in Florida state. You should check it out, as I am quite sure you have a good case (based on what you are saying). Stopping someone and requesting a search based on your skin colour (assuming you are black or hispanic) is clearly illegal and especially Florida has strong litigative responses to this kind of activity. The police district would probably lose such a case in court and you would even be entitled to punitive compensation. Also, the officer himself would probably settle with you in order not to get suspended. A police officer suspended for such could lose pesnion privilieges up to 10 years, not a very nice thing for ANY officer.
Again, the original topic here (Bush vs Kerry) has nothing to do with this issue. I have been pulled over myself and after denying them the priviliege to search my car they let me go. If you did not know the law at the moment and therefore forfeited your rights, that is unfortunate, but again, is not something the police should be blamed for. They just took advatage of you volunteering your compliance. It is not a good thing that people don't know their basic rights as a citizen, but again, their lack of knowledge is not the fault of the president of United States.