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The scarcity of physicians is also being used to push another, more controversial proposal in Juneau - medical tort reform.
Jim Jordan, executive director of the Alaska State Medical Association, told the Senate Labor and Commerce committee in hearings earlier this month that his association estimates Alaska needs about 470 more doctors to be at the national average of the ratio practicing physicians to population.
House Bill 102, sponsored by Rep. Bill Stoltze, R-Chugiak, would give the state medical board flexibility to waive Alaska's current two-year residency requirement for doctors trained outside the United States.
The bill is moving fast in the Legislature. It passed the House Feb. 24 and as of March 16 it was in the Senate.
Rick Urion, director of the state Division of Occupational Licensing, said he strongly supports HB 102.
"Our biggest problem is that the current law gives no discretion to the board," in waiving requirements in selected cases. Urion said he would support similar flexibility for other occupational licensing boards.
"We could solve a lot of problems," in recruiting skilled professionals if boards had flexibility, Urion said.
Dr. George Stewart, an Anchorage physician, told the committee that his clinic, which specializes in critical care medicine, has shortages in specialties like diabetes and neurology. Stewart has been trying to recruit another partner for the clinic for six years and has found only two candidates who were interested. One was trained in Venezuela and the other in the United Kingdom.
Both were highly trained and experienced and were interested in Alaska, but would not deal with the state's two-year residency requirement. Both are now working elsewhere in the United States, one in the University of Texas hospital burn unit, and the other as head of the pulmonary unit at the University of Pittsburgh.
As Alaska's population grows and ages, these problems will get worse, Stewart warned.
Physicians also lined up to support Senate Bill 67, which would limit "non-economic" damages in medical malpractice lawsuits.
The bill, now in the Senate Judiciary Committee, would limit non-economic, or pain and suffering damages, to $350,000 on malpractice awards. It would not affect awards for economic damages, meaning loss of income, or awards for attorneys' fees and costs.
Sen. Ralph Seekins, R-Fairbanks, is the sponsor of SB 67. Proponents of the bill argue it would help lower high costs of malpractice insurance for medical providers and would encourage insurance companies to even offer the coverage.
There is sharp opposition from trial attorneys and the AARP, however. A similar bill failed last year.
Sen. Johnny Ellis, D-Anchorage, said there's no assurance that passage of the legislation would actually result in lower costs of malpractice insurance. Ellis, who is the minority leader in the Senate, said he agrees with the AARP that there should be a greater focus within the health community on error reduction in medical practices.
Jordan, of the state medical association, said there's no guarantee that a limit on non-economic damages would lower malpractice coverage costs, but after California adopted a similar limit several years ago, the increases in costs slowed.
Dr. Michael Haugen, an Anchorage physician, told the committee that it's hard to recruit young doctors to Alaska; and the high cost of malpractice insurance is a big factor.
Haugen said many practicing physicians in the state are getting older and approaching retirement. He believes current shortages will be exacerbated unless young doctors can be recruited.
He also said that if older physicians are unable to get malpractice insurance many would quit practicing rather than risk being sued and losing assets accumulated over their careers.
"In our group, 40 percent of us are over 50. If we lost malpractice coverage we couldn't practice because of the chance of being sued," Haugen said.
Mike Powers of Fairbanks Memorial Hospital told the committee that his institution currently has shortages and is trying to recruit 19 physicians in different categories. Rod Betit, president of the Alaska Hospital Association, said his members are particularly short in family practice physicians.
"Alaska does have some advantages in recruiting young doctors, the environment for outdoor recreation being one, and the fact that we don't have managed care here is seen as a big plus," Betit said.
But Alaska's two big negatives are the nation's highest percentage of uninsured people and the cost and availability of malpractice insurance, he said.
"This is a targeted bill," Betit said. "We can't totally solve this problem, but we felt we could do something about non-economic damages."
Tim Bradner can be reached at tim.bradner@alaskajournal.com.
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