When she was told in early June that Dr. Diane Campbell had abruptly left the Fontaine Medical Center in East Harwich, Pamela Scott Hanrahan was more than a little upset. For about seven years Campbell had been an attentive, caring primary care doctor for her family.
“She was the kind of person who would literally lean in and listen to you,” Hanrahan said.
But Campbell's departure left her scrambling to find a new primary care physician. She's put her name in at Outer Cape Health Services in Harwich as well as at Fontaine, and while her brother was able to find an urgent care nurse practitioner to ensure that her elderly parents are covered, she has yet to find a new doctor for her family.
Representatives of both Cape Cod Healthcare, which operates the Fontaine Medical Center, and Outer Cape Health Services say the situation is not unusual. In an April study, the Association of American Medical Colleges projected a shortfall of 122,000 physicians nationally by 2032. And given the Cape's growing elderly population, high cost of living, especially housing prices—particularly on the Lower and Outer Cape—the situation is even more acute here.
“To have a candidate call and say they are very interested, we have to be very careful with them, and make sure they do the math and due diligence. We don't want them to get here and find they can't live,” said Pat Nadle, CEO of Outer Cape Health Services.
“It's a supply and demand issue,” said Jean Butler, Employed Physician Group Senior Vice President at Cape Cod Healthcare. With the Cape's high population of seniors, the demand here is greater than in other areas, she added.
Cape Cod Healthcare has three new primary care physicians starting over the next 12 months, she said. Two are being recruited for Fontaine. Both will be full time. One of the doctors who left the East Harwich facility, Jane Craig, was part time, so coverage will increase.
“We're interviewing quite a bit now and have some good candidates,” Butler said. Turnover, she added, is not unusual, and while she acknowledged the departure of the two physicians from Fontaine, she said she could not go into details about why they left.
“We know it's definitely difficult for them when it's a primary care physician who leaves,” Butler said. All appointments were rescheduled with other practitioners, either at Fontaine or another of the company's community partners. “There's nobody showing up at Fontaine who isn't seeing a provider,” she said.
Nadle said Outer Cape Health Services was aware of the departure of the two doctors from Fontaine and has been working with Cape Cod Healthcare to transition patients and find providers.
“We do collaborate on a regular basis,” she said. The organization has the same difficulty in recruiting doctors, although it has an advantage. It's coverage area, the Outer Cape, is considered rural, with reduced access to primary care. Doctors who opt to join Outer Cape Health Services can earn loan forgiveness through the National Health Service Corps.
“That's a very helpful recruiting tool,” Nadle said. Paying back medical school loans can be “like having a mortgage payment,” she said, and over the course of three to five years, a physicians can have most or even all of the loan forgiven. Five or six of Outer Cape Health Service's current physicians are in that program, she said.
The agency also has a newly graduating doctor beginning next week who attended Barnstable High School and is moving back to the Cape. “We got really lucky in recruiting her,” Nadle said. Housing costs have such a “huge impact” that many of the agency's hires are able to come here because they have family ties and thus a place to live. Outer Cape Health Services have facilities in Harwich, Wellfleet and Provincetown; the latter is particularly difficult to staff because of housing, Nadle said.
Nurse practitioners and other advanced practitioners are also filling provider slots, she said. Three of the agency's nurses went back to school to gain more training to become nurse practitioners.
It's not easy to start over after losing a doctor with whom you've developed a rapport, Hanrahan said, but the first step is finding a new one.
“I hope we can get some more doctors on Cape Cod,” she said.